Provider Demographics
NPI:1568762672
Name:LEBLANC, AMY M (PA-C)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:M
Last Name:LEBLANC
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:250 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-2598
Mailing Address - Country:US
Mailing Address - Phone:603-227-7000
Mailing Address - Fax:603-216-3800
Practice Address - Street 1:85 SPRING ST STE 2A1
Practice Address - Street 2:
Practice Address - City:LACONIA
Practice Address - State:NH
Practice Address - Zip Code:03246-3113
Practice Address - Country:US
Practice Address - Phone:603-524-1600
Practice Address - Fax:603-227-7556
Is Sole Proprietor?:No
Enumeration Date:2010-10-25
Last Update Date:2024-10-31
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Provider Licenses
StateLicense IDTaxonomies
NH0798363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH0798OtherLICENSE