Individual
LORI LEONARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
6 MATHIS DR NW, ROME, GA 30165-1242
(706) 233-9023
(706) 235-1585
Mailing address
PO BOX 80883, ATHENS, GA 30608-0883
(706) 549-8114
(706) 549-7558
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
RN123700
GA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN123700
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003146775
—
GA
Enumeration date
03/18/2014
Last updated
06/01/2022
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