Individual
MRS. NINA COLEMAN LEONARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPNP-PC, PMHCNS-BC
Contact information
Practice address
102 LAKESHORE DR STE B, SAINT MARYS, GA 31558-3875
(912) 882-3800
(912) 882-3303
Mailing address
102 LAKESHORE DR STE B, SAINT MARYS, GA 31558-3875
(912) 882-3800
(912) 882-3303
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN044413
GA
363LP0200X
Pediatric Nurse Practitioner
RN044413
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003133857A
—
GA
05
—
003133857B
—
GA
Enumeration date
01/07/2011
Last updated
12/02/2020
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