Provider Demographics
NPI:1750198974
Name:LEATHERS, KATHRYN FLANNERY (APRN)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:FLANNERY
Last Name:LEATHERS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:FLANNERY
Other - Last Name:LEATHERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2027 61ST ST
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77551-1401
Mailing Address - Country:US
Mailing Address - Phone:409-766-0950
Mailing Address - Fax:
Practice Address - Street 1:2027 61ST ST
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77551-1401
Practice Address - Country:US
Practice Address - Phone:097-894-0224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-11
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1181412363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner