Provider Demographics
NPI:1902413073
Name:LECONTE, RUCHAMA T (LPN)
Entity Type:Individual
Prefix:MRS
First Name:RUCHAMA
Middle Name:T
Last Name:LECONTE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:RUCHAMA
Other - Middle Name:T
Other - Last Name:LECONTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:898 READ ST
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-6199
Mailing Address - Country:US
Mailing Address - Phone:185-749-2629
Mailing Address - Fax:
Practice Address - Street 1:898 READ ST
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-6199
Practice Address - Country:US
Practice Address - Phone:185-749-2629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-23
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN88870164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse