Provider Demographics
NPI:1396883716
Name:LENAZ, LEONA R (CFNP)
Entity type:Individual
Prefix:
First Name:LEONA
Middle Name:R
Last Name:LENAZ
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1835 SAVOY DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30341-1072
Mailing Address - Country:US
Mailing Address - Phone:770-590-8311
Mailing Address - Fax:770-590-8313
Practice Address - Street 1:790 CHURCH ST NE STE 335
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-8957
Practice Address - Country:US
Practice Address - Phone:770-590-8311
Practice Address - Fax:770-590-8313
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2021-06-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN11010191363L00000X
GARN193714363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA349156122AMedicaid
GA202I503405OtherMEDICARE PTAN
GA349156122CMedicaid
GA349156122RMedicaid
FL109754200Medicaid
GA349156122VMedicaid