MEDICARE: LEANNA NICOLE GONZALEZ FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	2324420	MA

General Provider Information

NPI Number	:	1932913936
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEANNA NICOLE GONZALEZ FNP-C

Provider Business Mailing Address
First Line	:	450 PARADISE RD
Second Line	:
City	:	SWAMPSCOTT
State	:	MA
Zip	:	01907-1471
Country	:	US
Telephone Number	:	781-691-9366
Fax Number	:

Provider Business Practice Location Address
First Line	:	450 PARADISE RD
Second Line	:
City	:	SWAMPSCOTT
State	:	MA
Zip	:	01907-1471
Country	:	US
Telephone Number	:	781-691-9366
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/03/2025
Last Update Date	:	02/03/2025

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Directions to “ LEANNA NICOLE GONZALEZ FNP-C” Practice Location

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