Provider Demographics
NPI:1740974237
Name:LEONARD, ALLISON (RN)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:LEONARD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 GLOUCESTER ST
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-1666
Mailing Address - Country:US
Mailing Address - Phone:518-410-3874
Mailing Address - Fax:
Practice Address - Street 1:329 SAND CREEK RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-2938
Practice Address - Country:US
Practice Address - Phone:518-459-1333
Practice Address - Fax:833-843-9387
Is Sole Proprietor?:No
Enumeration Date:2023-06-07
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY846212163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool