Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 35077456L | OH |
N | 207V00000X | Obstetrician & Gynecologist | ME128504 | FL |
Y | 207VX0000X | Obstetrician | ME128504 | FL |
NPI | 1457331142 |
---|---|
Provider Name | Kathryn Hegland Leenhouts |
First Address | Brandon, FL 33511-5710 |
Second Address | Brandon, FL 33511-5710 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2006 |
Last Update Date | 15/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0059550 | (05) | OH |