Provider Demographics
NPI:1679649701
Name:CULP-LEONARD, KRISTY ANNE (CNM)
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:ANNE
Last Name:CULP-LEONARD
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1208 SIERRA AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-2642
Mailing Address - Country:US
Mailing Address - Phone:408-295-6726
Mailing Address - Fax:
Practice Address - Street 1:7933 WREN AVE
Practice Address - Street 2:SUITE D
Practice Address - City:GILROY
Practice Address - State:CA
Practice Address - Zip Code:95020-4996
Practice Address - Country:US
Practice Address - Phone:408-847-1739
Practice Address - Fax:408-847-5146
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN522056367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife