Provider Demographics
NPI:1720054992
Name:MCLEOD, KATHLEEN B (FNP-BC)
Entity type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:B
Last Name:MCLEOD
Suffix:
Gender:
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5210 E FARNESS DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-2140
Mailing Address - Country:US
Mailing Address - Phone:520-525-9433
Mailing Address - Fax:520-849-7441
Practice Address - Street 1:5210 E FARNESS DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2140
Practice Address - Country:US
Practice Address - Phone:520-525-9433
Practice Address - Fax:520-849-7441
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP1315363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ880353Medicaid
AZ880353Medicaid
AZP46216Medicare UPIN