Provider Demographics
NPI:1790783660
Name:DRAGONE, LEANNE LENEE (CRNP)
Entity Type:Individual
Prefix:
First Name:LEANNE
Middle Name:LENEE
Last Name:DRAGONE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:LEANNE
Other - Middle Name:
Other - Last Name:HUGGINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRNP
Mailing Address - Street 1:9009 CORPORATE LAKE DRIVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634
Mailing Address - Country:US
Mailing Address - Phone:612-642-7442
Mailing Address - Fax:
Practice Address - Street 1:9009 CORPORATE LAKE DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-2367
Practice Address - Country:US
Practice Address - Phone:612-642-7442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP008242363LA2200X
FLAPRN9390325363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA080305LLBMedicare ID - Type Unspecified
PAP33063Medicare UPIN