Provider Demographics
NPI:1801360094
Name:MERRITT, LEAUNA MITCHELL (CPNP-PC)
Entity Type:Individual
Prefix:
First Name:LEAUNA
Middle Name:MITCHELL
Last Name:MERRITT
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 PACIFIC AVE
Mailing Address - Street 2:
Mailing Address - City:SHARPSBURG
Mailing Address - State:GA
Mailing Address - Zip Code:30277-6958
Mailing Address - Country:US
Mailing Address - Phone:404-840-2497
Mailing Address - Fax:
Practice Address - Street 1:1111 BULLSBORO DR
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-2182
Practice Address - Country:US
Practice Address - Phone:770-683-3739
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-22
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN198728363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics