Provider Demographics
NPI:1962159640
Name:LEONHARDT, ALINA (RN)
Entity type:Individual
Prefix:
First Name:ALINA
Middle Name:
Last Name:LEONHARDT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ALINA
Other - Middle Name:
Other - Last Name:PALVOVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:150 PINE STATE ST
Mailing Address - Street 2:
Mailing Address - City:LILLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27546-9414
Mailing Address - Country:US
Mailing Address - Phone:910-814-2425
Mailing Address - Fax:910-814-2429
Practice Address - Street 1:150 PINE STATE ST
Practice Address - Street 2:
Practice Address - City:LILLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27546-9414
Practice Address - Country:US
Practice Address - Phone:910-814-2425
Practice Address - Fax:910-814-2429
Is Sole Proprietor?:No
Enumeration Date:2022-03-03
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC267258163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse