Provider Demographics
NPI:1679322986
Name:SKINNER, LEIGH-ANNE (RN, IBCLC)
Entity type:Individual
Prefix:
First Name:LEIGH-ANNE
Middle Name:
Last Name:SKINNER
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10645 CAULEY CREEK DR
Mailing Address - Street 2:
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30097-7855
Mailing Address - Country:US
Mailing Address - Phone:770-778-3734
Mailing Address - Fax:
Practice Address - Street 1:10645 CAULEY CREEK DR
Practice Address - Street 2:
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30097-7855
Practice Address - Country:US
Practice Address - Phone:770-778-3734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-17
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAL-308312163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant