Provider Demographics
NPI:1073396743
Name:HULO, LEANDRA (LPN)
Entity Type:Individual
Prefix:
First Name:LEANDRA
Middle Name:
Last Name:HULO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6970 CLEVELAND RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT MORRIS
Mailing Address - State:NY
Mailing Address - Zip Code:14510-9617
Mailing Address - Country:US
Mailing Address - Phone:585-443-0952
Mailing Address - Fax:
Practice Address - Street 1:6970 CLEVELAND RD
Practice Address - Street 2:
Practice Address - City:MOUNT MORRIS
Practice Address - State:NY
Practice Address - Zip Code:14510-9617
Practice Address - Country:US
Practice Address - Phone:585-443-0952
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-16
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY344348164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse