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Individual

LEA WOMACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AGNP

Contact information

Practice address
971 LAKELAND DR STE 250, JACKSON, MS 39216-4620
(601) 200-5864
(601) 200-0579
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(601) 200-5864
(225) 765-9196

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
903157
MS

Other

Enumeration date
02/12/2019
Last updated
04/09/2026
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