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General NPI Number Information
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NPI Number | 1639783426
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Entity Type | Individual
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Provider Name | KIMBERLY LEAHY-SMITH CNA
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Gender | Female
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Dates
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Enumeration Date | 08/31/2020
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Last Update Date | 11/04/2020
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Provider Practice Location Address
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Address Line | 122 RHAPSODY CT
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City | LAKE PLACID
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State | FL
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Zip | 33852-9205
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Country | US
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Telephone | 812-718-9090
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Fax | 812-718-9090
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Provider Business Mailing Address
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Address Line | 122 RHAPSODY CT
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City | LAKE PLACID
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State | FL
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Zip | 33852-9205
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Country | US
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Telephone | 866-416-3398
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Fax | 856-556-3773
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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 | 2278H0200X
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Taxonomy Name | Home Health Certified Respiratory Therapist
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License Number | CAN398323
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2279H0200X
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Taxonomy Name | Home Health Registered Respiratory Therapist
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License Number | CAN398323
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number | CAN398323
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License Number State | FL
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