Individual
NICOLE ALYCE LESANTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-4291
Mailing address
300 LONGWOOD AVE, ATTN: FLOOR 10 EAST, BOSTON, MA 02115-5724
(617) 355-4291
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
NP95000968
CA
363LP0200X
Pediatric Nurse Practitioner
NPP37735
RI
363LP0200X
Pediatric Nurse Practitioner
Primary
RN2264257
MA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
NPP95000968
CA
Other
Enumeration date
01/31/2013
Last updated
07/18/2017
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