Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | APRN3225652 | FL |
N | 363LF0000X | Nurse Practitioner - Family Medicine | RN277105 | GA |
NPI | 1003300138 |
---|---|
Provider Name | Gillian Leeder |
First Address | Oxford, FL 34484-2951 |
Second Address | Safety Harbor, FL 34695-6605 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2018 |
Last Update Date | 02/08/2021 |