Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 1013 | NH |
NPI | 1003177239 |
---|---|
Provider Name | Carol Lynn Leonard |
First Address | Concord, NH 03301-4817 |
Second Address | Concord, NH 03301-4817 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2012 |
Last Update Date | 05/06/2012 |