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General NPI Number Information
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NPI Number | 1053101501
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Entity Type | Individual
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Provider Name | JILLIAN LEIKAUSKAS APRN
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Gender | Female
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Dates
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Enumeration Date | 05/08/2025
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Last Update Date | 08/15/2025
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Provider Practice Location Address
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Address Line | 111 COLCHESTER AVE
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City | BURLINGTON
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State | VT
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Zip | 05401-1473
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Country | US
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Telephone | 802-847-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 89 E MAIN ST
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City | RICHMOND
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State | VT
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Zip | 05477-7741
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Country | US
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Telephone | 978-490-0416
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 101.0138029
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License Number State | VT
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Taxonomy #2
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Taxonomy Code | 163WX0200X
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Taxonomy Name | Oncology Registered Nurse
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License Number | 026.0150405
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License Number State | VT
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