Provider Demographics
NPI:1619442951
Name:LAFOUNTAIN, LEAH CARTER (NP)
Entity type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:CARTER
Last Name:LAFOUNTAIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:62 WESTBURY PARK WAY
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29910-8825
Mailing Address - Country:US
Mailing Address - Phone:843-380-2400
Mailing Address - Fax:843-380-2440
Practice Address - Street 1:1203 PARIS AVE
Practice Address - Street 2:
Practice Address - City:PORT ROYAL
Practice Address - State:SC
Practice Address - Zip Code:29935-2118
Practice Address - Country:US
Practice Address - Phone:843-380-2400
Practice Address - Fax:843-380-2440
Is Sole Proprietor?:No
Enumeration Date:2018-10-12
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN235704363LP0808X
SC23367363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health