Provider Demographics
NPI:1043550197
Name:KLINE, LEAH (PA)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:KLINE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:201 GREAT OAKS TRL
Mailing Address - Street 2:
Mailing Address - City:WADSWORTH
Mailing Address - State:OH
Mailing Address - Zip Code:44281-9430
Mailing Address - Country:US
Mailing Address - Phone:330-336-9500
Mailing Address - Fax:330-336-3377
Practice Address - Street 1:201 GREAT OAKS TRL
Practice Address - Street 2:
Practice Address - City:WADSWORTH
Practice Address - State:OH
Practice Address - Zip Code:44281-9430
Practice Address - Country:US
Practice Address - Phone:330-336-9500
Practice Address - Fax:330-336-3377
Is Sole Proprietor?:No
Enumeration Date:2013-02-27
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.003725363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical