Provider Demographics
NPI:1265825962
Name:MCGEHEE, LEAH SMITH (FNP-C)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:SMITH
Last Name:MCGEHEE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:C
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:201 HWY 51 N
Mailing Address - Street 2:SUITE A
Mailing Address - City:BROOKHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:39601
Mailing Address - Country:US
Mailing Address - Phone:601-833-5333
Mailing Address - Fax:
Practice Address - Street 1:201 HIGHWAY 51 N STE A
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:MS
Practice Address - Zip Code:39601-2653
Practice Address - Country:US
Practice Address - Phone:601-833-5333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-05
Last Update Date:2017-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR871958363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily