Provider Demographics
NPI:1487908372
Name:STONE, LEANNE A (MS, PA-C)
Entity type:Individual
Prefix:
First Name:LEANNE
Middle Name:A
Last Name:STONE
Suffix:
Gender:F
Credentials:MS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 BEL AIR SOUTH PKWY
Mailing Address - Street 2:#1535
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-6091
Mailing Address - Country:US
Mailing Address - Phone:410-569-0044
Mailing Address - Fax:
Practice Address - Street 1:5 BEL AIR SOUTH PKWY
Practice Address - Street 2:#1535
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-6091
Practice Address - Country:US
Practice Address - Phone:410-569-0044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-31
Last Update Date:2015-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0004920363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant