Provider Demographics
NPI:1881334092
Name:LEONARD, JAYNIE LYNN (RN)
Entity type:Individual
Prefix:MRS
First Name:JAYNIE
Middle Name:LYNN
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 1:5113 MAPLE SPRINGS ELLERY RD
Mailing Address - Street 2:
Mailing Address - City:BEMUS POINT
Mailing Address - State:NY
Mailing Address - Zip Code:14712-9723
Mailing Address - Country:US
Mailing Address - Phone:716-499-7113
Mailing Address - Fax:
Practice Address - Street 1:5113 MAPLE SPRINGS ELLERY RD
Practice Address - Street 2:
Practice Address - City:BEMUS POINT
Practice Address - State:NY
Practice Address - Zip Code:14712-9723
Practice Address - Country:US
Practice Address - Phone:716-499-7113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-29
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7511778-01163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse