Individual
LEIGH BOSTICK WOMBLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
512 LEVEE STREET, BOX 310, ROSEDALE, MS 38769-0310
(662) 759-6806
(662) 759-6771
Mailing address
512 LEVEE STREET, BOX 310, ROSEDALE, MS 38769-0310
(662) 759-6806
(662) 759-6771
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN210599
GA
364SF0001X
Family Health Clinical Nurse Specialist
R544779
MS
Other
Enumeration date
03/31/2011
Last updated
03/02/2018
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