Individual
LEAH WILSON KEITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1211 DINAH SHORE BLVD, WINCHESTER, TN 37398-1107
(931) 967-6669
Mailing address
477 JASMINE DR, MADISON, AL 35757-4602
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1-173475
AL
363L00000X
Nurse Practitioner
Primary
33217
TN
Other
Enumeration date
01/06/2023
Last updated
01/20/2023
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