Provider Demographics
NPI:1316902752
Name:LEATON, ROXANNE L (RN C)
Entity type:Individual
Prefix:MRS
First Name:ROXANNE
Middle Name:L
Last Name:LEATON
Suffix:
Gender:F
Credentials:RN C
Other - Prefix:
Other - First Name:ROXANNE
Other - Middle Name:
Other - Last Name:BUSMIRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6981 CASWELL RD
Mailing Address - Street 2:
Mailing Address - City:BYRON
Mailing Address - State:NY
Mailing Address - Zip Code:14422
Mailing Address - Country:US
Mailing Address - Phone:585-548-7314
Mailing Address - Fax:
Practice Address - Street 1:41 MAIN ST
Practice Address - Street 2:
Practice Address - City:OAKFIELD
Practice Address - State:NY
Practice Address - Zip Code:14125-1014
Practice Address - Country:US
Practice Address - Phone:585-948-8077
Practice Address - Fax:585-948-9159
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY463756163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice