Provider Demographics
NPI:1891895405
Name:RICHBOURG, LEANNE (RN)
Entity Type:Individual
Prefix:
First Name:LEANNE
Middle Name:
Last Name:RICHBOURG
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:923 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-3917
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3000 NEW BERN AVE
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-1231
Practice Address - Country:US
Practice Address - Phone:919-350-6462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC104721163WC2100X, 163WG0600X, 163WW0000X, 163WX1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WC2100XNursing Service ProvidersRegistered NurseContinence Care
Not Answered163WG0600XNursing Service ProvidersRegistered NurseGerontology
Not Answered163WW0000XNursing Service ProvidersRegistered NurseWound Care
Not Answered163WX1500XNursing Service ProvidersRegistered NurseOstomy Care