Individual
KATHERINE PENNY LEONARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
7227 N US HIGHWAY 1 STE 100, PORT ST JOHN, FL 32927-5034
(321) 637-1595
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 434-1981
(321) 951-7408
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN3139742
FL
363LF0000X
Family Nurse Practitioner
124329
AR
363LF0000X
Family Nurse Practitioner
3139742
FL
363LF0000X
Family Nurse Practitioner
APRN3139742
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDING
MEDICARE
FL
Enumeration date
07/19/2017
Last updated
07/26/2021
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