Provider Demographics
NPI:1013294974
Name:GARMON, LEAH JEANNEANE (RN)
Entity Type:Individual
Prefix:MS
First Name:LEAH
Middle Name:JEANNEANE
Last Name:GARMON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14750 4TH ST
Mailing Address - Street 2:436
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-3707
Mailing Address - Country:US
Mailing Address - Phone:301-604-4448
Mailing Address - Fax:
Practice Address - Street 1:14750 4TH ST
Practice Address - Street 2:436
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-3707
Practice Address - Country:US
Practice Address - Phone:301-604-4448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-07
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR163695163W00000X
DCRN1017923163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse