Provider Demographics
NPI:1902194962
Name:LEONARD, SUSAN D (CRT, RCP)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:D
Last Name:LEONARD
Suffix:
Gender:F
Credentials:CRT, RCP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:343 TECHNOLOGY DR
Mailing Address - Street 2:SUITE 1110
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-7949
Mailing Address - Country:US
Mailing Address - Phone:919-780-5900
Mailing Address - Fax:919-780-5905
Practice Address - Street 1:343 TECHNOLOGY DR
Practice Address - Street 2:SUITE 1110
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-7949
Practice Address - Country:US
Practice Address - Phone:919-780-5900
Practice Address - Fax:919-780-5905
Is Sole Proprietor?:No
Enumeration Date:2011-07-12
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA 4248227800000X
2278P1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified
No2278P1004XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedPulmonary Diagnostics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC4248OtherNORTH CAROLINA RESPIRATORY CARE BOARD