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General NPI Number Information
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NPI Number | 1902303225
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Entity Type | Individual
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Provider Name | LEONARDO ENRIQUE CORDERO FNP
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Gender | Male
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Dates
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Enumeration Date | 04/12/2018
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Last Update Date | 05/22/2024
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Provider Practice Location Address
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Address Line | 2311 HENRY CLOWER BLVD STE B
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City | SNELLVILLE
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State | GA
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Zip | 30078-7418
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Country | US
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Telephone | 770-979-3796
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Fax |
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Provider Business Mailing Address
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Address Line | 4424 HUGH HOWELL RD STE D
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City | TUCKER
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State | GA
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Zip | 30084-4905
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Country | US
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Telephone | 700-979-3796
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Fax | 770-979-0939
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN232819
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | C-APN.0101857-C-NP
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 305376
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License Number State | AZ
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | N361555210
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License Number State | WA
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN232819
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License Number State | GA
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