Basic Information
Provider Information
NPI: 1073954376
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DOBBS
FirstName: LEIGH
MiddleName: ELLEN LARKIN
NamePrefix:  
NameSuffix:  
Credential: APRN, FNP-BC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 106 NATE WHIPPLE HWY
Address2: SUITE 101
City: CUMBERLAND
State: RI
PostalCode: 028641428
CountryCode: US
TelephoneNumber: 4016582020
FaxNumber: 4016583612
Practice Location
Address1: 106 NATE WHIPPLE HWY
Address2: SUITE 101
City: CUMBERLAND
State: RI
PostalCode: 028641428
CountryCode: US
TelephoneNumber: 4016582020
FaxNumber: 4016583612
Other Information
ProviderEnumerationDate: 07/15/2013
LastUpdateDate: 03/27/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XRN2269914MAN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
363LF0000XAPRN00559RIY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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