Individual
LEANN MARIE MICHEALS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1434 PORTER STREET, RICHARD BARQUIST ARMY HEALTH CLINIC, FT. DETRICK, MD 20172
(301) 619-7175
Mailing address
210 MURDOCH SQ SE, LEESBURG, VA 20175-3766
(703) 777-3191
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0017000755
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001142909
RN LICENSURE
VA
01
—
0017000755
NP LICENSURE
VA
Enumeration date
12/18/2006
Last updated
08/04/2022
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