Provider Demographics
NPI:1194058966
Name:LEIGH-SIMMS, KATHLEEN JANE (ANP)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:JANE
Last Name:LEIGH-SIMMS
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 CRESCENT PARK W
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:PA
Mailing Address - Zip Code:16365
Mailing Address - Country:US
Mailing Address - Phone:814-723-3300
Mailing Address - Fax:814-726-9412
Practice Address - Street 1:2 CRESCENT PARK W
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:PA
Practice Address - Zip Code:16365
Practice Address - Country:US
Practice Address - Phone:814-723-3300
Practice Address - Fax:814-726-9412
Is Sole Proprietor?:No
Enumeration Date:2009-09-11
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF305182-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health