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General NPI Number Information
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NPI Number | 1346792587
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Entity Type | Individual
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Provider Name | KRISTEN LEINO APRN
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Gender | Female
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Dates
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Enumeration Date | 11/03/2016
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Last Update Date | 08/05/2020
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Provider Practice Location Address
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Address Line | 1658 ST VINCENTS WAY STE 310
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City | MIDDLEBURG
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State | FL
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Zip | 32068-8459
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Country | US
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Telephone | 904-602-4450
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Fax | 904-602-2787
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Provider Business Mailing Address
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Address Line | 1658 ST VINCENTS WAY STE 310
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City | MIDDLEBURG
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State | FL
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Zip | 32068-8459
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Country | US
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Telephone | 904-602-4450
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Fax | 904-602-2787
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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 | ARNP 9325269
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License Number State | FL
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