Provider Demographics
NPI:1396971198
Name:VACHON, LEONIE S (NP)
Entity type:Individual
Prefix:
First Name:LEONIE
Middle Name:S
Last Name:VACHON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:155 WELLNESS WAY
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16803-6702
Mailing Address - Country:US
Mailing Address - Phone:814-231-7000
Mailing Address - Fax:814-231-7098
Practice Address - Street 1:2121 OLD GATESBURG RD
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16803-2290
Practice Address - Country:US
Practice Address - Phone:814-231-7277
Practice Address - Fax:814-231-1582
Is Sole Proprietor?:No
Enumeration Date:2009-06-08
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX719031363L00000X
PASP013123363L00000X
NC5004727363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L14346Medicare PIN