Provider Demographics
NPI:1669722013
Name:MATHER, LEEANNE S (APRN)
Entity type:Individual
Prefix:MRS
First Name:LEEANNE
Middle Name:S
Last Name:MATHER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MISS
Other - First Name:LEEANNE
Other - Middle Name:
Other - Last Name:SCHOENFELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:7 HOLLAND WAY FL 1
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-2997
Mailing Address - Country:US
Mailing Address - Phone:603-772-5528
Mailing Address - Fax:603-777-1296
Practice Address - Street 1:3 ALUMNI DR
Practice Address - Street 2:SUITE 201
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-2119
Practice Address - Country:US
Practice Address - Phone:603-772-5528
Practice Address - Fax:603-777-1296
Is Sole Proprietor?:No
Enumeration Date:2012-09-13
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH064302-23363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3078641Medicaid
NH3078941Medicaid