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General NPI Number Information
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NPI Number | 1568176048
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Entity Type | Individual
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Provider Name | LAUREN DUNCAN LEATHERLAND
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Gender | Female
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Dates
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Enumeration Date | 01/10/2023
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Last Update Date | 01/10/2023
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Provider Practice Location Address
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Address Line | 802 22ND ST
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City | COLUMBUS
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State | GA
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Zip | 31904-8823
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Country | US
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Telephone | 706-576-5773
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Fax |
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Provider Business Mailing Address
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Address Line | 2415 COUNTRY CLUB RD
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City | COLUMBUS
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State | GA
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Zip | 31906-1129
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Country | US
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Telephone | 706-580-0811
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Fax |
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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 | RN289323
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License Number State | GA
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