Leah Michelle Bagley, NP-C
Nurse Practitioner, Family in Shaw Afb, SC. Individual provider (NPI-1).
NPI number1962030809
StatusActive
Last updated in NPPESNov 25, 2024
Details
- NPI
- 1962030809
- Entity type
- Individual (NPI-1)
- Name
- Leah Michelle Bagley
- Credential
- NP-C
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 27, 2020
- Certification date
- Nov 25, 2024
- Last updated
- Nov 25, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 24751 | SC | Yes |
| 363LF0000X | Nurse Practitioner, Family | RN262574 | GA |
Practice location
420 Polifka DrShaw Afb, SC 29152-5100
Phone 803-895-6191
Mailing address
420 Polifka DrShaw Afb, SC 29152-5100
Phone 803-895-6191
Other practice locations
114 Gateway Corporate Blvd Ste 300
Columbia, SC 29203-8801
Columbia, SC 29203-8801
Phone 839-200-7815 · Fax 803-891-7085
7430 College St
Irmo, SC 29063-2903
Irmo, SC 29063-2903
Phone 839-200-7810 · Fax 803-891-7085
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All 9 Family Nurse Practitioner providers in Shaw Afb · All 96 providers in Shaw Afb
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