Individual
MS. DEANNA A LEEDOM
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
655 W 8TH ST, UFJP ANESTHESIA DEPT., JACKSONVILLE, FL 32209-6511
(904) 244-4195
(904) 244-4908
Mailing address
PO BOX 44008, UFJP PROVIDER ENROLLMENT, JACKSONVILLE, FL 32231-4008
(904) 244-3199
(904) 244-3425
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARNP211934
FL
Other
Enumeration date
03/11/2006
Last updated
07/08/2007
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