Provider Demographics
NPI:1164875415
Name:LEININGER, KRISTY LYNN (RN, MSN)
Entity Type:Individual
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First Name:KRISTY
Middle Name:LYNN
Last Name:LEININGER
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Gender:F
Credentials:RN, MSN
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Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:6100 ROCKSIDE WOODS BLVD N
Mailing Address - Street 2:SUITE 425
Mailing Address - City:INDEPENDENCE
Mailing Address - State:OH
Mailing Address - Zip Code:44131-2366
Mailing Address - Country:US
Mailing Address - Phone:216-643-2780
Mailing Address - Fax:216-524-0111
Practice Address - Street 1:6100 ROCKSIDE WOODS BLVD N
Practice Address - Street 2:SUITE 425
Practice Address - City:INDEPENDENCE
Practice Address - State:OH
Practice Address - Zip Code:44131-2366
Practice Address - Country:US
Practice Address - Phone:216-643-2780
Practice Address - Fax:216-524-0111
Is Sole Proprietor?:No
Enumeration Date:2016-07-21
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH019671363LA2200X
OH355882163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse