Individual
LEANDRA LYNETTE DAVIDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
3201 ROUSE DR, FAYETTEVILLE, NC 28306-8324
(910) 261-3481
Mailing address
3201 ROUSE DR, FAYETTEVILLE, NC 28306-8324
(910) 261-3481
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
255560
NC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
255560
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1588137764
NPI
NC
01
—
5013914
PMHNPLICENSE
NC
Enumeration date
01/09/2019
Last updated
02/11/2023
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