Provider Demographics
NPI:1700493236
Name:LAMIRANDE, LESLIE MARIE (RN)
Entity type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:MARIE
Last Name:LAMIRANDE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 NAYLOR CIR
Mailing Address - Street 2:
Mailing Address - City:BALDWINSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13027-6190
Mailing Address - Country:US
Mailing Address - Phone:315-638-6123
Mailing Address - Fax:315-638-6170
Practice Address - Street 1:VAN BUREN ELEMENTARY SCHOOL
Practice Address - Street 2:14 FORD STREET
Practice Address - City:BALDWINSVILLE
Practice Address - State:NY
Practice Address - Zip Code:13027
Practice Address - Country:US
Practice Address - Phone:316-638-6123
Practice Address - Fax:315-638-6170
Is Sole Proprietor?:No
Enumeration Date:2020-09-29
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY714381-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool