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General NPI Number Information
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NPI Number | 1316338825
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Entity Type | Individual
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Provider Name | LEAH GARGAS NP
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Gender | Female
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Dates
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Enumeration Date | 02/05/2015
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Last Update Date | 08/12/2015
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Provider Practice Location Address
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Address Line | 206 E BLUE STARR DR
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City | CLAREMORE
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State | OK
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Zip | 74017-4223
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Country | US
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Telephone | 918-341-8100
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Fax |
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Provider Business Mailing Address
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Address Line | 12410EE 86TH N ST
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City | OWASSO
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State | OK
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Zip | 74055-2500
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Country | US
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Telephone | 918-272-0033
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Fax | 918-272-0039
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 115383
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License Number State | OK
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