Doctor Name: | LEILA M GAINES |
NPI Number: | 1861596405 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APN-C |
License Number: | 26NN09759200 |
Business Practice Address: | 353 12th St S Brigantine, NJ - 082032211 |
Business Phone Number: | 6092667557 |
Business Fax Number: | 6092664450 |
Mailing Address: | 353 12th Street South, Brigantine Medical Group BRIGANTINE |
State: | NJ |
Postal Code: | 08203 |
Phone Number: | 6092667557 |
Fax Number: | 6092664450 |
NPI Enumeration Date: | 09/12/2006 |
NPI Last Update Date: | 03/12/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | 26NN09759200 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |