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General NPI Number Information
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NPI Number | 1649573346
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Entity Type | Individual
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Provider Name | LEIGHTON KENNEDY PMHNP, BC
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Gender | Male
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Dates
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Enumeration Date | 12/19/2010
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Last Update Date | 02/20/2023
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Provider Practice Location Address
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Address Line | 8101 SANDY SPRING RD STE 250
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City | LAUREL
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State | MD
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Zip | 20707-3527
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Country | US
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Telephone | 202-355-8587
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Fax | 202-478-2919
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Provider Business Mailing Address
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Address Line | PO BOX 212
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City | SIMPSONVILLE
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State | MD
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Zip | 21150-0212
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Country | US
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Telephone | 202-355-8587
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Fax | 202-478-2919
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RN215628
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 0024183634
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 5773
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License Number State | MN
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R203481
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License Number State | MD
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