Healthcare Provider Details

I. General information

NPI: 1720137052
Provider Name (Legal Business Name): LEANNE LOTT FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 ROBINSON ST
BINGHAMTON NY
13904-1735
US

IV. Provider business mailing address

425 ROBINSON ST
BINGHAMTON NY
13904-1775
US

V. Phone/Fax

Practice location:
  • Phone: 607-773-4061
  • Fax: 607-773-4656
Mailing address:
  • Phone: 607-773-4061
  • Fax: 607-773-4656

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LC1500X
TaxonomyCommunity Health Nurse Practitioner
License Number320017
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number348405
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number455475
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: