Provider Demographics
NPI:1568767994
Name:MUHAMMAD, LEONORA (AGPCNP-BC)
Entity type:Individual
Prefix:DR
First Name:LEONORA
Middle Name:
Last Name:MUHAMMAD
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2930 WILLOW CREEK ESTATES DR
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63031-1662
Mailing Address - Country:US
Mailing Address - Phone:314-564-5556
Mailing Address - Fax:
Practice Address - Street 1:2930 WILLOW CREEK ESTATES DR
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63031-1662
Practice Address - Country:US
Practice Address - Phone:314-564-5556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-15
Last Update Date:2025-01-06
Deactivation Date:2024-11-12
Deactivation Code:
Reactivation Date:2024-12-10
Provider Licenses
StateLicense IDTaxonomies
MO2007029534163W00000X
MO2023009842363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse