JACOB PATRICK LEIDHOLM CNP NPI 1922765197

NPI Information

NPI: 1922765197
Provider Name: JACOB PATRICK LEIDHOLM, CNP
Classification: Nurse Practitioner - 363LA2100X
Entity Type: Individual

Specialization: Acute Care

PECOS Registration: Yes

Address:
55 LAKE AVE N
WORCESTER, MA
ZIP 01655
Phone: (508) 334-3452
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Jacob Patrick Leidholm, CNP is an acute care nurse practitioner in Worcester, MA with 3 years of experience. Jacob Patrick Leidholm, CNP NPI is 1922765197. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

55 LAKE AVE N
WORCESTER, MA
ZIP 01655-002
Phone: (508) 334-3452

The NPI 1922765197 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/23/2021 and was last updated on 3/21/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363L00000X	Nurse Practitioner		RN2361554	MASSACHUSETTS	No
2	363LA2100X	Nurse Practitioner	Acute Care	RN2361554	MASSACHUSETTS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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