Healthcare Provider Details

I. General information

NPI: 1619616919
Provider Name (Legal Business Name): EMMA LEONARD MSN, CNM, WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2022
Last Update Date: 08/19/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

617 RIVERSIDE AVE
BURLINGTON VT
05401-1601
US

IV. Provider business mailing address

617 RIVERSIDE AVE
BURLINGTON VT
05401-1601
US

V. Phone/Fax

Practice location:
  • Phone: 802-864-6309
  • Fax:
Mailing address:
  • Phone: 802-864-6309
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number101.0135474
License Number StateVT
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number101.0135474
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: