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General NPI Number Information
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NPI Number | 1750175444
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Entity Type | Individual
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Provider Name | MCKEINZIE LEIKERT FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 04/07/2025
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Last Update Date | 11/26/2025
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Provider Practice Location Address
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Address Line | 272 N MAIN ST UNIT 101
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City | CAMBRIDGE
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State | VT
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Zip | 05444-9810
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Country | US
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Telephone | 802-644-5114
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Fax |
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Provider Business Mailing Address
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Address Line | 1605 LAPLAND RD
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City | WATERVILLE
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State | VT
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Zip | 05492-9701
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Country | US
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Telephone | 802-793-9428
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 101.0137852
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License Number State | VT
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