Provider Demographics
NPI:1780604231
Name:LEONE, KATHERINE J (MN, ARNP)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:J
Last Name:LEONE
Suffix:
Gender:F
Credentials:MN, ARNP
Other - Prefix:
Other - First Name:KATHY
Other - Middle Name:
Other - Last Name:PEARCE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MN, ARNP
Mailing Address - Street 1:PO BOX 5096
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98227-5096
Mailing Address - Country:US
Mailing Address - Phone:360-738-2200
Mailing Address - Fax:360-752-5674
Practice Address - Street 1:4545 CORDATA PKWY
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-7123
Practice Address - Country:US
Practice Address - Phone:360-738-2200
Practice Address - Fax:360-752-5674
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30005390363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1780604231Medicaid
WA0261489OtherL&I AND CRIME VICTIMS
AKNP313WAMedicaid
WA0151PEOtherREGENCE
WA7203234OtherAETNA
ID806598400Medicaid
MT4300864Medicaid
ID806598400Medicaid
AKNP313WAMedicaid
WAG8892464Medicare PIN