Healthcare Provider Details

I. General information

NPI: 1790725786
Provider Name (Legal Business Name): LESLEY ABIGAIL STONE FNP-BC, RN, LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 03/07/2024
Certification Date: 03/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

575 TURNPIKE ST STE 25
NORTH ANDOVER MA
01845-5937
US

IV. Provider business mailing address

575 TURNPIKE ST
NORTH ANDOVER MA
01845-5924
US

V. Phone/Fax

Practice location:
  • Phone: 978-290-4646
  • Fax:
Mailing address:
  • Phone: 978-290-4822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN2318230
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number112226
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code163WH1000X
TaxonomyHospice Registered Nurse
License Number2318230
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: