Healthcare Provider Details

I. General information

NPI: 1588936421
Provider Name (Legal Business Name): WHITNEY LEDA KLEIN CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: WHITNEY LEDA MILLER

II. Dates (important events)

Enumeration Date: 02/08/2012
Last Update Date: 10/31/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 GOODMAN ST
CINCINNATI OH
45219-2364
US

IV. Provider business mailing address

PO BOX 636256 CENTRAL CREDENTIALING
CINCINNATI OH
45263-6256
US

V. Phone/Fax

Practice location:
  • Phone: 513-584-7372
  • Fax: 513-584-2605
Mailing address:
  • Phone: 513-585-5502
  • Fax: 513-585-5511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCOA.13151-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: