Leeann Lynn Flood, LPN/RCS

Individual provider Active NPI Licensed Practical Nurse · Antigo, WI

NPI 1992958581 · NPPES record last updated Oct 28, 2008

Key facts

NPI
1992958581
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
307564-031 (WI)
Practice address
209 E 5TH Ave
Antigo, WI 54409-2713
Phone
(715) 623-6846
Fax
(715) 623-6846
NPI assigned
Oct 28, 2008
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
307564-031WIMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 307564-031 WI Yes

Addresses

Primary practice location

209 E 5TH Ave
Antigo, WI 54409-2713

Mailing address

209 E 5TH Ave
Antigo, WI 54409-2713
Phone (715) 623-6846

Other identifiers

IdentifierTypeStateIssuer
3973870830MedicaidWI

Other providers in Antigo, WI

All providers in Antigo, WI · Licensed Practical Nurse in Wisconsin

Sources for this page

Verify at the official NPI Registry.