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General NPI Number Information
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NPI Number | 1619442951
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Entity Type | Individual
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Provider Name | LEAH CARTER LAFOUNTAIN NP
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Gender | Female
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Dates
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Enumeration Date | 10/12/2018
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Last Update Date | 06/06/2023
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Provider Practice Location Address
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Address Line | 25 CLARK SUMMIT DR STE F201
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City | BLUFFTON
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State | SC
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Zip | 29910-4205
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Country | US
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Telephone | 843-757-4737
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Fax |
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Provider Business Mailing Address
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Address Line | 25 CLARK SUMMIT DR STE F201
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City | BLUFFTON
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State | SC
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Zip | 29910-4205
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Country | US
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Telephone | 912-256-2311
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RN235704
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 23367
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License Number State | SC
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