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General NPI Number Information
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NPI Number | 1619495116
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Entity Type | Individual
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Provider Name | DANI NICOLE LEONARD PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/05/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 4851 E PICKARD ST
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City | MT PLEASANT
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State | MI
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Zip | 48858-2029
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Country | US
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Telephone | 989-775-1600
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2579
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City | MIDLAND
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State | MI
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Zip | 48641-2579
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Country | US
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Telephone | 989-205-4500
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Fax | 989-794-5942
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 5601008352
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License Number State | MI
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