Provider Demographics
NPI:1588477889
Name:DAVIS, LEONARD JR (LPN)
Entity type:Individual
Prefix:
First Name:LEONARD
Middle Name:
Last Name:DAVIS
Suffix:JR
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8480 LIMEKILN PIKE APT 422-3
Mailing Address - Street 2:
Mailing Address - City:WYNCOTE
Mailing Address - State:PA
Mailing Address - Zip Code:19095-2801
Mailing Address - Country:US
Mailing Address - Phone:215-800-8019
Mailing Address - Fax:
Practice Address - Street 1:8480 LIMEKILN PIKE APT 422-3
Practice Address - Street 2:
Practice Address - City:WYNCOTE
Practice Address - State:PA
Practice Address - Zip Code:19095-2801
Practice Address - Country:US
Practice Address - Phone:215-800-8019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN290603164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse