Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 209.002858 | IL |
NPI | 1225351323 |
---|---|
Provider Name | Mrs. Sharon Kay Leonard |
First Address | Pekin, IL 61554-9726 |
Second Address | Peoria, IL 61637-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/03/2010 |
Last Update Date | 04/03/2010 |