Provider Information for 1639662497
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KERRI LYNN LEONARD
Sex: Female
NPI: 1639662497
Last Updated: 2024-09-11
Certification Date: 2024-09-11
Certification Date: 2024-09-11
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1639662497 | ||||||||||||
| Enumeration Date | 2018-06-07 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 108 GILES AVE STE 102 WILMINGTON, NC 28403-4759 United States Phone: 910-231-5569 | Fax: | ||||||||||||
| Primary Practice Address | 108 GILES AVE WILMINGTON, NC 28403-4784 United States Phone: 910-769-9691 | Fax: | ||||||||||||
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