Individual
CHRISTIAN LEATHLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
45 CHAPEL ST, SOUTH PORTLAND, ME 04106-2716
(734) 776-2425
Mailing address
45 CHAPEL ST, SOUTH PORTLAND, ME 04106-2716
(734) 776-2425
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
CNP231283
ME
Other
Enumeration date
07/11/2023
Last updated
07/11/2023
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