Provider Demographics
NPI:1437509684
Name:LEANDRE, LYNN (RN)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:LEANDRE
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 1:2 FRANKA PL APT 9
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-3985
Mailing Address - Country:US
Mailing Address - Phone:845-475-4314
Mailing Address - Fax:
Practice Address - Street 1:2 FRANKA PL APT 9
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-3985
Practice Address - Country:US
Practice Address - Phone:845-475-4314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-20
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY732575163W00000X, 163WE0003X, 163WP0808X
NJ26NR21471700163W00000X
NY318801164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No163WE0003XNursing Service ProvidersRegistered NurseEmergency
No164W00000XNursing Service ProvidersLicensed Practical Nurse