Provider Demographics
NPI:1083451223
Name:FRODEMA, LESLIE ANNE (NP)
Entity type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:ANNE
Last Name:FRODEMA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:571 MAIN ST FL 1
Mailing Address - Street 2:
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190-1843
Mailing Address - Country:US
Mailing Address - Phone:617-773-9198
Mailing Address - Fax:617-769-9952
Practice Address - Street 1:571 MAIN ST FL 1
Practice Address - Street 2:
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-1843
Practice Address - Country:US
Practice Address - Phone:617-773-9198
Practice Address - Fax:617-769-9952
Is Sole Proprietor?:No
Enumeration Date:2024-07-15
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MARN175976363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health