Individual
EMILY MARIE LEIDIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP BC-C
Contact information
Practice address
636 S MONTE VISTA DR, GLADE SPRING, VA 24340-2712
(276) 429-5163
Mailing address
1021 W OAKLAND AVE STE 310, JOHNSON CITY, TN 37604-2192
(423) 302-6565
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
0024180071
VA
Other
Enumeration date
09/25/2020
Last updated
04/26/2024
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