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NPI Code Detail

MEDICARE: MRS. LEENA MARIA PAUL NP

MEDICARE: MRS. LEENA MARIA PAUL NP
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
1363L00000XNurse Practitioner5013193NC
2363LP2300XPrimary Care Nurse Practitioner5013193NC
3363LF0000XFamily Nurse Practitioner336956NY
4363LF0000XFamily Nurse Practitioner5013193NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1497033724
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LEENA MARIA PAUL NP
Provider Business Mailing Address
First Line : 5960 FAIRVIEW RD STE 500
Second Line :
City : CHARLOTTE
State : NC
Zip : 28210-3113
Country : US
Telephone Number : 704-495-6334
Fax Number : 844-624-2406
Provider Business Practice Location Address
First Line : 11030 GOLF LINKS DR STE 100
Second Line :
City : CHARLOTTE
State : NC
Zip : 28277-8047
Country : US
Telephone Number : 704-918-1934
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2011
Last Update Date : 04/20/2023

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