Provider Demographics
NPI:1295538858
Name:GILLESPIE, LEONYROSE FAJARDO (RN)
Entity type:Individual
Prefix:MRS
First Name:LEONYROSE
Middle Name:FAJARDO
Last Name:GILLESPIE
Suffix:
Gender:
Credentials:RN
Other - Prefix:MS
Other - First Name:LEONYROSE
Other - Middle Name:FAJARDO
Other - Last Name:LOCQUIAO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:7605 ROCK BROOK DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32222-4226
Mailing Address - Country:US
Mailing Address - Phone:904-608-4931
Mailing Address - Fax:
Practice Address - Street 1:317 6TH AVE STE 400
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-4108
Practice Address - Country:US
Practice Address - Phone:641-780-1114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-29
Last Update Date:2025-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9536263163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse