Individual
MRS. GENNITHA MARIE MCLEOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
30 HOLMES DRIVE, OXFORD, AL 36203
(256) 403-3534
(256) 403-3541
Mailing address
30 HOLMES DRIVE, OXFORD, AL 36203
(256) 403-3534
(256) 403-3541
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN237968
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003178587A
—
GA
01
—
202503I184
MEDICARE PTAN
GA
Enumeration date
07/20/2016
Last updated
03/04/2021
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