Provider Demographics
NPI:1225812118
Name:LEONARD, CAROL C (BSN,RNC,IBCLC)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:C
Last Name:LEONARD
Suffix:
Gender:F
Credentials:BSN,RNC,IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 BENS POINT RD
Mailing Address - Street 2:
Mailing Address - City:CHURCH HILL
Mailing Address - State:MD
Mailing Address - Zip Code:21623-1214
Mailing Address - Country:US
Mailing Address - Phone:410-708-3616
Mailing Address - Fax:
Practice Address - Street 1:401 BENS POINT RD
Practice Address - Street 2:
Practice Address - City:CHURCH HILL
Practice Address - State:MD
Practice Address - Zip Code:21623-1214
Practice Address - Country:US
Practice Address - Phone:410-708-3616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR082860163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant