Provider Demographics
NPI:1790257756
Name:LEIGH, KATHERINE HOPE (APRN)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:HOPE
Last Name:LEIGH
Suffix:
Gender:F
Credentials:APRN
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 1272
Mailing Address - Street 2:
Mailing Address - City:SNEADS
Mailing Address - State:FL
Mailing Address - Zip Code:32460-1272
Mailing Address - Country:US
Mailing Address - Phone:850-251-0240
Mailing Address - Fax:
Practice Address - Street 1:3015 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:MARIANNA
Practice Address - State:FL
Practice Address - Zip Code:32446-2339
Practice Address - Country:US
Practice Address - Phone:850-526-3577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-31
Last Update Date:2018-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3307032363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily