Provider Demographics
NPI:1356024467
Name:THOMAS, LEANA MARIA (APRN)
Entity type:Individual
Prefix:
First Name:LEANA
Middle Name:MARIA
Last Name:THOMAS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 SPRINGTREE LN
Mailing Address - Street 2:
Mailing Address - City:SOUTH BERWICK
Mailing Address - State:ME
Mailing Address - Zip Code:03908-2113
Mailing Address - Country:US
Mailing Address - Phone:603-817-5395
Mailing Address - Fax:
Practice Address - Street 1:24 CHESTNUT ST STE 4
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-7301
Practice Address - Country:US
Practice Address - Phone:603-817-5395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-08
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH090306-23363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner