Healthcare Provider Details

I. General information

NPI: 1730769456
Provider Name (Legal Business Name): KAITLYN ELIZABETH LEAHEY DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2021
Last Update Date: 07/14/2025
Certification Date: 07/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 245099
TUCSON AZ
85724-5099
US

IV. Provider business mailing address

PO BOX 245099
TUCSON AZ
85724-5099
US

V. Phone/Fax

Practice location:
  • Phone: 520-694-0111
  • Fax:
Mailing address:
  • Phone: 520-694-0111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberOT020865
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberR4503
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: