Provider Demographics
NPI:1154326809
Name:LEAL, ANN L (NP)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:L
Last Name:LEAL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:874 PURCHASE ST
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02740-6232
Mailing Address - Country:US
Mailing Address - Phone:508-992-6553
Mailing Address - Fax:508-990-7558
Practice Address - Street 1:874 PURCHASE ST
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-6232
Practice Address - Country:US
Practice Address - Phone:508-992-6553
Practice Address - Fax:508-990-7558
Is Sole Proprietor?:No
Enumeration Date:2005-06-18
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA123505363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA402778OtherBCBSRIBLUECHIP
MANP1039OtherBCBCMA
MA000000044636OtherBMC
MA23361-1OtherBCBSRI
MA42221OtherCHILDRENSMEDSECURITY
MA0320684Medicaid
MA0022515OtherNEIGHBORHOOD HEALTH PLAN
MA0320684Medicaid
MAS52960Medicare UPIN