Provider Demographics
NPI:1053497370
Name:LEIGHT, KIMBERLY HULL (MS, PSYNP)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:HULL
Last Name:LEIGHT
Suffix:
Gender:F
Credentials:MS, PSYNP
Other - Prefix:MS
Other - First Name:KIMBERLY
Other - Middle Name:HULL
Other - Last Name:PIMENTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, NP
Mailing Address - Street 1:1454 E LOS ARBOLES DR
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85284-2459
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1232 E BROADWAY RD
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-1511
Practice Address - Country:US
Practice Address - Phone:480-784-1514
Practice Address - Fax:480-967-3528
Is Sole Proprietor?:No
Enumeration Date:2006-10-29
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN054775363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health