Provider Demographics
NPI:1518491224
Name:NICEK, ANNA LEU (MD)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:LEU
Last Name:NICEK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:MAE
Other - Last Name:LEU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7450 KESSLER ST STE 300
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66204-2550
Mailing Address - Country:US
Mailing Address - Phone:913-632-2900
Mailing Address - Fax:913-632-2900
Practice Address - Street 1:7450 KESSLER ST STE 300
Practice Address - Street 2:
Practice Address - City:SHAWNEE MISSION
Practice Address - State:KS
Practice Address - Zip Code:66204-2550
Practice Address - Country:US
Practice Address - Phone:913-632-2900
Practice Address - Fax:913-632-2999
Is Sole Proprietor?:No
Enumeration Date:2017-04-19
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
KS04-44679207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program