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General NPI Number Information
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NPI Number | 1902642697
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Entity Type | Individual
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Provider Name | LEANNE NICHOLSON FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 07/02/2024
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 49 KENT RD
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City | HOWELL
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State | NJ
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Zip | 07731-2452
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Country | US
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Telephone | 732-901-2928
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Fax | 732-901-3980
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Provider Business Mailing Address
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Address Line | 27 HAVERFORD CT UNIT 1
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City | FREEHOLD
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State | NJ
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Zip | 07728-4905
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Country | US
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Telephone | 732-832-9932
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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 | 26NJ15092600
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License Number State | NJ
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