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General NPI Number Information
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NPI Number | 1518882349
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Entity Type | Individual
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Provider Name | LEAH GERRED
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Gender | Female
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Dates
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Enumeration Date | 08/11/2026
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Last Update Date | 08/11/2026
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Provider Practice Location Address
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Address Line | 3609 PHOENIX AVE
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City | FORT SMITH
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State | AR
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Zip | 72903-6430
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Country | US
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Telephone | 479-646-3711
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Fax | 479-648-8266
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Provider Business Mailing Address
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Address Line | 402 RIDGE DR
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City | SALLISAW
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State | OK
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Zip | 74955-3081
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Country | US
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Telephone | 479-646-3711
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Fax | 479-648-8266
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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 | 163WP0200X
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Taxonomy Name | Pediatric Registered Nurse
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License Number | 225138
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License Number State | OK
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