Doctor Name: | MRS. LEILA SMITH BRAGG |
NPI Number: | 1144204918 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSN, APRN, BC, FNP |
License Number: | RN033517 |
Business Practice Address: | 328 W Main St Swainsboro, GA - 304013104 |
Business Phone Number: | 4782377801 |
Business Fax Number: | 4782373883 |
Mailing Address: | 940 Oaklawn Dr, SWAINSBORO |
State: | GA |
Postal Code: | 304015729 |
Phone Number: | 4782376758 |
Fax Number: | |
NPI Enumeration Date: | 12/05/2005 |
NPI Last Update Date: | 10/15/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | RN033517 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |