Provider Demographics
NPI:1750007969
Name:PEREDNIA, LEEANN (RN, BSN, CLC)
Entity type:Individual
Prefix:
First Name:LEEANN
Middle Name:
Last Name:PEREDNIA
Suffix:
Gender:F
Credentials:RN, BSN, CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 PEPPERBUSH LN
Mailing Address - Street 2:
Mailing Address - City:NORTH ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02760-4761
Mailing Address - Country:US
Mailing Address - Phone:508-641-8354
Mailing Address - Fax:
Practice Address - Street 1:12 PEPPERBUSH LN
Practice Address - Street 2:
Practice Address - City:NORTH ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02760-4761
Practice Address - Country:US
Practice Address - Phone:508-641-8354
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-19
Last Update Date:2023-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
346176174N00000X, 174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Single Specialty