Provider Demographics
NPI:1467018226
Name:DANIEL, LEENA (MSN,WHNP-BC,IBCLC)
Entity Type:Individual
Prefix:
First Name:LEENA
Middle Name:
Last Name:DANIEL
Suffix:
Gender:F
Credentials:MSN,WHNP-BC,IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7607 WHETHERSFIELD PL
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-6317
Mailing Address - Country:US
Mailing Address - Phone:301-658-7135
Mailing Address - Fax:
Practice Address - Street 1:13 C STREET, SUITE D
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707
Practice Address - Country:US
Practice Address - Phone:301-617-2767
Practice Address - Fax:301-617-3971
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-16
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR168170363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health