Provider Demographics
NPI:1790725786
Name:STONE, LESLEY ABIGAIL (FNP-BC, RN, LICSW)
Entity Type:Individual
Prefix:
First Name:LESLEY
Middle Name:ABIGAIL
Last Name:STONE
Suffix:
Gender:F
Credentials:FNP-BC, RN, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 TURNPIKE ST
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-5924
Mailing Address - Country:US
Mailing Address - Phone:978-290-4822
Mailing Address - Fax:
Practice Address - Street 1:575 TURNPIKE ST STE 25
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-5937
Practice Address - Country:US
Practice Address - Phone:978-290-4646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2318230363L00000X
MA1122261041C0700X
MA2318230163WH1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No163WH1000XNursing Service ProvidersRegistered NurseHospice