Provider Demographics
NPI:1083370993
Name:MCNALL, LEANNE GRACE (RN)
Entity Type:Individual
Prefix:MS
First Name:LEANNE
Middle Name:GRACE
Last Name:MCNALL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 JASON ST APT 306
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02476-6450
Mailing Address - Country:US
Mailing Address - Phone:978-771-6520
Mailing Address - Fax:
Practice Address - Street 1:6 JASON ST APT 306
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02476-6450
Practice Address - Country:US
Practice Address - Phone:978-771-6520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-15
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2351958163WM0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WM0102XNursing Service ProvidersRegistered NurseMaternal NewbornGroup - Single Specialty