Healthcare Provider Details

I. General information

NPI: 1679649701
Provider Name (Legal Business Name): KRISTY ANNE CULP-LEONARD CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 01/26/2022
Certification Date: 01/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7933 WREN AVE SUITE D
GILROY CA
95020-4996
US

IV. Provider business mailing address

1208 SIERRA AVE
SAN JOSE CA
95126-2642
US

V. Phone/Fax

Practice location:
  • Phone: 408-847-1739
  • Fax: 408-847-5146
Mailing address:
  • Phone: 408-295-6726
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberRN522056
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: