Garcia Leach, Gwendolyn Denise

Garcia Leach, Gwendolyn Denise is an individual health care provider with primary practice located at 195 W Illinois Ave , Southern Pines NC 28387-5808. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Garcia Leach, Gwendolyn Denise can be contacted via phone (910) 692-2444.

Contact Information

Primary practice address
195 W Illinois Ave Southern Pines NC 28387-5808
Phone: (910) 692-2444
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 5006800 North Carolina

Profile Details

NPI number 1316363252
LBN Legal business name Garcia Leach, Gwendolyn Denise
Credentials Certified Pediatric Nurse Practitioner (CPNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 17th, 2014
Last updated Sep 16th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316363252 NPPES
North Carolina MEDICAID 8902600

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