Individual
CURTIS GRADIE LEIPOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
6549 TOWN CENTER DR, CLARKSTON, MI 48346-4824
(248) 620-6400
Mailing address
702 S GAINSBOROUGH AVE, ROYAL OAK, MI 48067-2985
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704257453
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704257453
STATE LICENSE
MI
Enumeration date
11/09/2021
Last updated
11/09/2021
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