Provider Demographics
NPI:1447684592
Name:LEONE, ELISE D (CNP)
Entity type:Individual
Prefix:
First Name:ELISE
Middle Name:D
Last Name:LEONE
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:307 W MAIN ST
Mailing Address - Street 2:STE C
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-2400
Mailing Address - Country:US
Mailing Address - Phone:330-677-3628
Mailing Address - Fax:330-677-3626
Practice Address - Street 1:5105 SOM CENTER ROAD
Practice Address - Street 2:STE 202
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094
Practice Address - Country:US
Practice Address - Phone:440-953-5760
Practice Address - Fax:440-953-5761
Is Sole Proprietor?:No
Enumeration Date:2013-08-26
Last Update Date:2022-02-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OHNP-15021363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9338635OtherPARTNERS PHYSICIAN GROUP MEDICARE GROUP #
OH2551671OtherPARTNERS PHYSICIAN GROUP MEDICAID GROUP #
OH0090912Medicaid
OH1841239274OtherPARTNERS PHYSICIAN GROUP TYPE 2 NPI #
OH1841239274OtherPARTNERS PHYSICIAN GROUP TYPE 2 NPI #