MARY KAY LEACH ARNP NPI 1235199134

NPI Information

  • NPI: 1235199134
  • Provider Name: MARY KAY LEACH, ARNP
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • Address: 1000 MAR WALT DR
    INTERNAL MEDICINE DEPARTMENT
    FORT WALTON BEACH, FL
    ZIP 32547
  • Phone: (850) 863-8202

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NPI Details

Mary Kay Leach, ARNP is a family nurse practitioner in Fort Walton Beach, FL. Mary Kay Leach, ARNP NPI is 1235199134. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1000 MAR WALT DR
INTERNAL MEDICINE DEPARTMENT
FORT WALTON BEACH, FL
ZIP 32547-708
Phone: (850) 863-8202
Fax: (850) 862-6148

The enumeration date for this NPI number is 3/24/2006 and was last updated on 5/19/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamilyARNP9196496FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1305445400MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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