Provider Demographics
NPI:1639339302
Name:KERNAN, LEAH KATHYANN (DO)
Entity Type:Individual
Prefix:DR
First Name:LEAH
Middle Name:KATHYANN
Last Name:KERNAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 459
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:TX
Mailing Address - Zip Code:76534-0459
Mailing Address - Country:US
Mailing Address - Phone:254-553-4126
Mailing Address - Fax:
Practice Address - Street 1:BLDG 87008, 16TH ST
Practice Address - Street 2:REGIMENTAL AID STATION
Practice Address - City:FORT HOOD
Practice Address - State:TX
Practice Address - Zip Code:76544
Practice Address - Country:US
Practice Address - Phone:254-553-4126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP3015207P00000X
MI5101019536207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine