Provider Demographics
NPI:1275825556
Name:LEPPKE, ALLISON (NP-C)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:LEPPKE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850 E WEST CONNECTOR
Mailing Address - Street 2:
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30106-1246
Mailing Address - Country:US
Mailing Address - Phone:404-855-2246
Mailing Address - Fax:404-793-8481
Practice Address - Street 1:1850 E WEST CONNECTOR
Practice Address - Street 2:
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106-1246
Practice Address - Country:US
Practice Address - Phone:404-855-2246
Practice Address - Fax:404-793-8481
Is Sole Proprietor?:No
Enumeration Date:2011-05-05
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN204063363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily