Individual
LEONNA WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, FNP-C, CFCS,
Contact information
Practice address
79 WAWECUS ST STE 101, NORWICH, CT 06360-2182
(860) 886-2655
Mailing address
86 OTROBANDO AVE UNIT 30, NORWICH, CT 06360-2272
Taxonomy
Speciality
Code
Description
License number
State
163WG0100X
Gastroenterology Registered Nurse
10.098126
CT
363LF0000X
Family Nurse Practitioner
Primary
8156
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1275094385
—
CT
Enumeration date
03/29/2019
Last updated
05/09/2019
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