Provider Demographics
NPI:1477256691
Name:O'QUINN, LEIGH WILLINGHAM (FNP-C)
Entity Type:Individual
Prefix:
First Name:LEIGH
Middle Name:WILLINGHAM
Last Name:O'QUINN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 NORTHWIND DR
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31523-8902
Mailing Address - Country:US
Mailing Address - Phone:912-222-0490
Mailing Address - Fax:
Practice Address - Street 1:106 NORTHWIND DR
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31523-8902
Practice Address - Country:US
Practice Address - Phone:912-222-0490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN173503363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner