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General NPI Number Information
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NPI Number | 1215333117
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Entity Type | Individual
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Provider Name | MARIE LEON
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Gender | Female
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Dates
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Enumeration Date | 11/05/2014
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Last Update Date | 11/05/2014
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Provider Practice Location Address
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Address Line | 819 WORCESTER ST STE 3
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City | SPRINGFIELD
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State | MA
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Zip | 01151-1045
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Country | US
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Telephone | 413-543-6820
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Fax |
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Provider Business Mailing Address
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Address Line | 133 COMMANDER SHEA BLVD APT 810
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City | NORTH QUINCY
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State | MA
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Zip | 02171-1565
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Country | US
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Telephone | 617-894-5985
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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 | RN2278872
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License Number State | MA
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