Provider Demographics
NPI:1861692477
Name:LEONARD, DAWN ALLISON (RN, BSN)
Entity type:Individual
Prefix:MS
First Name:DAWN
Middle Name:ALLISON
Last Name:LEONARD
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 MERRIMAC ST
Mailing Address - Street 2:UNIT 701
Mailing Address - City:AMESBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01913-4011
Mailing Address - Country:US
Mailing Address - Phone:978-265-9407
Mailing Address - Fax:
Practice Address - Street 1:60 MERRIMAC ST
Practice Address - Street 2:UNIT 701
Practice Address - City:AMESBURY
Practice Address - State:MA
Practice Address - Zip Code:01913-4011
Practice Address - Country:US
Practice Address - Phone:978-265-9407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-21
Last Update Date:2007-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA146515163W00000X, 163WC1500X
FL9211910163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0387720Medicaid