Provider Demographics
NPI:1841723921
Name:LEONARD, KATHERINE (CNM, WHNP-BC)
Entity type:Individual
Prefix:MISS
First Name:KATHERINE
Middle Name:
Last Name:LEONARD
Suffix:
Gender:F
Credentials:CNM, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 HURFFVILLE CROSSKEYS RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-9340
Mailing Address - Country:US
Mailing Address - Phone:856-589-1414
Mailing Address - Fax:856-256-5772
Practice Address - Street 1:445 HURFFVILLE CROSSKEYS RD STE A
Practice Address - Street 2:
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-2337
Practice Address - Country:US
Practice Address - Phone:856-557-5573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-06
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25ME00061801367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0566756Medicaid
NJ581226AEEOtherMEDICARE PIN