Provider Demographics
NPI:1487981452
Name:KLEIN, LEIGH ANN (WHNP)
Entity type:Individual
Prefix:
First Name:LEIGH
Middle Name:ANN
Last Name:KLEIN
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 E MARSHALL AVE
Mailing Address - Street 2:SUITE 3000
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75601-5573
Mailing Address - Country:US
Mailing Address - Phone:903-315-2700
Mailing Address - Fax:903-236-2575
Practice Address - Street 1:705 E MARSHALL AVE
Practice Address - Street 2:SUITE 3000
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75601-5573
Practice Address - Country:US
Practice Address - Phone:903-315-2700
Practice Address - Fax:903-236-2575
Is Sole Proprietor?:No
Enumeration Date:2009-11-11
Last Update Date:2017-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX683702363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX752616977068OtherTRICARE
TX598448YMAFOtherMEDICARE
TX8HB308OtherBCBS
TX75-2616977-083OtherTRICARE