Provider Demographics
NPI:1003979634
Name:DILEVA, KATHLEEN LEFLAR (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:LEFLAR
Last Name:DILEVA
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 S MENNONITE RD
Mailing Address - Street 2:
Mailing Address - City:COLLEGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19426-2868
Mailing Address - Country:US
Mailing Address - Phone:610-831-5813
Mailing Address - Fax:
Practice Address - Street 1:443 GERMANTOWN PIKE
Practice Address - Street 2:
Practice Address - City:LAFAYETTE HILL
Practice Address - State:PA
Practice Address - Zip Code:19444-1813
Practice Address - Country:US
Practice Address - Phone:610-828-4060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP004737P363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health