Provider Demographics
NPI:1073528451
Name:LEOGRANDE, WENDY (NP)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:LEOGRANDE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 FLEMING ST STE 1
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28791-3541
Mailing Address - Country:US
Mailing Address - Phone:828-490-4444
Mailing Address - Fax:828-698-7077
Practice Address - Street 1:840 FLEMING ST STE 1
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28791-3541
Practice Address - Country:US
Practice Address - Phone:828-490-4444
Practice Address - Fax:828-698-7077
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2019-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201651363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily