Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | F304147-1 | NY |
NPI | 1003970641 |
---|---|
Provider Name | Ms. Lorraine Kay Leonard |
First Address | Lakewood, NY 14750-1308 |
Second Address | Rochester, NY 14618-3981 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2006 |
Last Update Date | 22/07/2015 |