Provider Demographics
NPI:1376155929
Name:LECLAIR, STEPHANY (MSN, APRN, A-GNP-C)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANY
Middle Name:
Last Name:LECLAIR
Suffix:
Gender:F
Credentials:MSN, APRN, A-GNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7748 BURNET LN
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34654-6302
Mailing Address - Country:US
Mailing Address - Phone:727-267-6830
Mailing Address - Fax:
Practice Address - Street 1:2445 COUNTRY PLACE BLVD STE 103
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34655-1102
Practice Address - Country:US
Practice Address - Phone:727-267-6830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-17
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC282725163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse