LEATHERMAN HEALTHCARE LLC NPI 1972250009

NPI Information

LEATHERMAN HEALTHCARE, LLC is a primary care nurse practitioner in Hagerstown, MD. LEATHERMAN HEALTHCARE, LLC NPI is 1972250009. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Former Legal Business Name Is Leatherman Healthcare, Llc.

The provider's business location address is:

118 E OAK RIDGE DR STE 2000
HAGERSTOWN, MD
ZIP 21740-890
Phone: (301) 678-1839
Fax: (301) 679-1740

The provider's authorized official is Gwenn Leatherman .
The authorized official title is Ceo and has the following contact phone number (301) 418-5828.

The CLIA number assigned to this NPI record is 21D2258708 - other - fnp owned pcp with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/8/2022 and was last updated on 11/23/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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