Provider Demographics
NPI:1326744913
Name:HEWLING, LEONIE TAMARA (LPN)
Entity Type:Individual
Prefix:
First Name:LEONIE
Middle Name:TAMARA
Last Name:HEWLING
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:588 VILLAGE RUN
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-5078
Mailing Address - Country:US
Mailing Address - Phone:770-695-1206
Mailing Address - Fax:
Practice Address - Street 1:267 LANGLEY DR STE 1008
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-6907
Practice Address - Country:US
Practice Address - Phone:678-754-4184
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPN102056164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse