Provider Demographics
NPI:1346564408
Name:LEIBOWITZ, KATHLEEN FANNING (MSN, RN, CPNP-AC)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:FANNING
Last Name:LEIBOWITZ
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Gender:F
Credentials:MSN, RN, CPNP-AC
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Other - First Name:
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Mailing Address - Street 1:8401 DATAPOINT DR
Mailing Address - Street 2:SUITE 500
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-5900
Mailing Address - Country:US
Mailing Address - Phone:210-614-0180
Mailing Address - Fax:210-566-5698
Practice Address - Street 1:8401 DATAPOINT DR
Practice Address - Street 2:SUITE 500
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-5900
Practice Address - Country:US
Practice Address - Phone:210-614-0180
Practice Address - Fax:210-566-5698
Is Sole Proprietor?:No
Enumeration Date:2010-03-18
Last Update Date:2010-03-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX740903363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner