Healthcare Provider Details

I. General information

NPI: 1396668554
Provider Name (Legal Business Name): LEO CHARLEBOIS NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 CHARLES ST
NORTH ATTLEBORO MA
02760-3104
US

IV. Provider business mailing address

54 CHARLES ST
NORTH ATTLEBORO MA
02760-3104
US

V. Phone/Fax

Practice location:
  • Phone: 508-409-7252
  • Fax: 508-409-7252
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPPLYING
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: