Healthcare Provider Details

I. General information

NPI: 1578076824
Provider Name (Legal Business Name): LEANNE ELIZABETH BYNOE CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2017
Last Update Date: 08/14/2024
Certification Date: 08/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 GENERAL ST
LAWRENCE MA
01841
US

IV. Provider business mailing address

34 KING ST
WILMINGTON MA
01887-1940
US

V. Phone/Fax

Practice location:
  • Phone: 978-683-4000
  • Fax:
Mailing address:
  • Phone: 978-427-9990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN2287982
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN2287982
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: