Provider Demographics
NPI:1932791019
Name:LEONARD, MARY CATHERINE (DNP, FNP-C)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:CATHERINE
Last Name:LEONARD
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 N 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:SANDPOINT
Mailing Address - State:ID
Mailing Address - Zip Code:83864-1301
Mailing Address - Country:US
Mailing Address - Phone:208-789-0181
Mailing Address - Fax:208-618-8622
Practice Address - Street 1:105 N 1ST AVE
Practice Address - Street 2:
Practice Address - City:SANDPOINT
Practice Address - State:ID
Practice Address - Zip Code:83864-1301
Practice Address - Country:US
Practice Address - Phone:208-789-0181
Practice Address - Fax:208-618-8622
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-09
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID60080363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily