Provider Demographics
NPI:1770271207
Name:KOSSAYDA, LEDA SUZANNE (APRN)
Entity type:Individual
Prefix:MS
First Name:LEDA
Middle Name:SUZANNE
Last Name:KOSSAYDA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:LEDA
Other - Middle Name:KOSSAYDA
Other - Last Name:SEALY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:32 POPPLE RD
Mailing Address - Street 2:
Mailing Address - City:NEW BOSTON
Mailing Address - State:NH
Mailing Address - Zip Code:03070-4911
Mailing Address - Country:US
Mailing Address - Phone:603-275-2655
Mailing Address - Fax:
Practice Address - Street 1:100 MCGREGOR ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102-3730
Practice Address - Country:US
Practice Address - Phone:603-669-0413
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-24
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2288981163W00000X
NH06318221163W00000X
NH06318223363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse