Healthcare Provider Details

I. General information

NPI: 1750007969
Provider Name (Legal Business Name): LEEANN PEREDNIA RN, BSN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2022
Last Update Date: 07/05/2026
Certification Date: 07/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 PEPPERBUSH LN
NORTH ATTLEBORO MA
02760-4761
US

IV. Provider business mailing address

12 PEPPERBUSH LN
NORTH ATTLEBORO MA
02760-4761
US

V. Phone/Fax

Practice location:
  • Phone: 508-641-8354
  • Fax:
Mailing address:
  • Phone: 508-641-8354
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberL-322993
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: