MEDICARE: MRS. STEPHANY LECLAIR MSN, APRN, A-GNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	282725	NC

General Provider Information

NPI Number	:	1376155929
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. STEPHANY LECLAIR MSN, APRN, A-GNP-C

Provider Business Mailing Address
First Line	:	7748 BURNET LN
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34654-6302
Country	:	US
Telephone Number	:	727-267-6830
Fax Number	:

Provider Business Practice Location Address
First Line	:	2445 COUNTRY PLACE BLVD STE 103
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34655-1102
Country	:	US
Telephone Number	:	727-267-6830
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2020
Last Update Date	:	01/13/2022

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