Provider Demographics
NPI:1215574306
Name:LEON, ANNE (NP)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:LEON
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 1:149 EDGECOMBE AVE APT B3
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10030-1195
Mailing Address - Country:US
Mailing Address - Phone:813-476-4615
Mailing Address - Fax:
Practice Address - Street 1:149 EDGECOMBE AVE APT B3
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10030-1195
Practice Address - Country:US
Practice Address - Phone:813-476-4615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-08
Last Update Date:2019-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY431594363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care