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General NPI Number Information
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NPI Number | 1306063565
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Entity Type | Individual
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Provider Name | KATHLEEN C LEOFFLER NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 10/18/2007
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Provider Practice Location Address
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Address Line | 1615 HIGHWAY 34 E
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City | NEWNAN
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State | GA
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Zip | 30265-1325
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Country | US
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Telephone | 770-252-6767
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Fax | 770-252-0021
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Provider Business Mailing Address
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Address Line | PO BOX 102321
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City | ATLANTA
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State | GA
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Zip | 30368-2321
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Country | US
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Telephone | 770-801-2500
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN143499
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License Number State | GA
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