Provider Demographics
NPI:1437946928
Name:GULLEY, LEAH S
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:S
Last Name:GULLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2195 MORGAN DR
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-7726
Mailing Address - Country:US
Mailing Address - Phone:704-340-3402
Mailing Address - Fax:
Practice Address - Street 1:2195 MORGAN DR
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-7726
Practice Address - Country:US
Practice Address - Phone:704-340-3402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered