Individual
LEISA DWAMENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
275 VARNUM AVE STE 208, LOWELL, MA 01854-2109
(978) 330-6335
(978) 355-1002
Mailing address
31 ONSET ST, WORCESTER, MA 01604-2013
(603) 674-6969
(603) 674-6969
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN2296460
MA
163W00000X
Registered Nurse
Primary
RN2296460
MH
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN2296460
MA
Other
Enumeration date
08/28/2025
Last updated
04/22/2026
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