Provider Demographics
NPI:1598901712
Name:GONZALEZ, LEANNE DENISE (NNP)
Entity Type:Individual
Prefix:MRS
First Name:LEANNE
Middle Name:DENISE
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:NNP
Other - Prefix:
Other - First Name:LEANNE
Other - Middle Name:DENISE
Other - Last Name:LYNCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NNP
Mailing Address - Street 1:2920 HIGHWOODS BLVD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-0010
Mailing Address - Country:US
Mailing Address - Phone:877-498-4490
Mailing Address - Fax:
Practice Address - Street 1:3000 NEW BERN AVENUE, 3RD FLOOR
Practice Address - Street 2:WAKE MED FACULTY PHYSICIANS, NEONATOLOGY
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610
Practice Address - Country:US
Practice Address - Phone:919-350-8545
Practice Address - Fax:919-350-8146
Is Sole Proprietor?:No
Enumeration Date:2008-12-17
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5004211363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal