Waller, Leah M

Waller, Leah M is an individual health care provider with primary practice located at 1 Meadows Pkwy , Vidalia GA 30474-8759. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Waller, Leah M can be contacted via phone (912) 535-5800.

Contact Information

Primary practice address
1 Meadows Pkwy Vidalia GA 30474-8759
Fax: (912) 535-5830
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 007734 Georgia

Profile Details

NPI number 1962873711
LBN Legal business name Waller, Leah M
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 19th, 2015
Last updated Oct 17th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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