Provider Demographics
NPI:1396993374
Name:ST. LEGER, ANN KATHRYN (PA-C)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:KATHRYN
Last Name:ST. LEGER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3998 RED LION RD STE 306
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19114-1441
Mailing Address - Country:US
Mailing Address - Phone:215-281-0800
Mailing Address - Fax:
Practice Address - Street 1:825 OLD LANCASTER RD STE 410
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-3236
Practice Address - Country:US
Practice Address - Phone:610-527-1165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA061433363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant