Individual
NATALYA LEACOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
3051 LINCOLN LOG WAY, MCDONOUGH, GA 30252-7673
(770) 940-0918
Mailing address
3051 LINCOLN LOG WAY, MCDONOUGH, GA 30252-7673
(770) 940-0918
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
RN261842
GA
Other
Enumeration date
03/02/2023
Last updated
03/02/2023
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