Provider Demographics
NPI:1144704487
Name:ALFINO, LEAH HEATHER (FNP-C)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:HEATHER
Last Name:ALFINO
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10224 WILLINGHAM RD
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-5273
Mailing Address - Country:US
Mailing Address - Phone:704-516-1805
Mailing Address - Fax:
Practice Address - Street 1:235 MEDICAL PARK RD STE 201
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-8546
Practice Address - Country:US
Practice Address - Phone:704-658-9211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-22
Last Update Date:2018-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCF045180598363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner