Provider Demographics
NPI:1063477685
Name:LEYENDECKER, KIMBERLY S (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:S
Last Name:LEYENDECKER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1395 S STATE ROAD 7
Mailing Address - Street 2:SUITE 450
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-9325
Mailing Address - Country:US
Mailing Address - Phone:561-798-1233
Mailing Address - Fax:561-798-1655
Practice Address - Street 1:1395 S STATE ROAD 7
Practice Address - Street 2:SUITE 450
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-9325
Practice Address - Country:US
Practice Address - Phone:561-798-1233
Practice Address - Fax:561-798-1655
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1535762363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology