Individual
LEAH GWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
901 PRINCE WILLIAM RD STE A, DELPHI, IN 46923-1759
(765) 564-3016
Mailing address
901 PRINCE WILLIAM RD STE A, DELPHI, IN 46923-1759
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28197607A
IN
363L00000X
Nurse Practitioner
Primary
71005660A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201313300
—
IN
01
—
855O
MEDICARE
IN
Enumeration date
08/15/2015
Last updated
12/19/2018
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