Provider Demographics
NPI:1558361840
Name:LEA, JESSICA W (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:W
Last Name:LEA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6310 LAMAR AVE
Mailing Address - Street 2:SUITE 230
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66202-4287
Mailing Address - Country:US
Mailing Address - Phone:913-262-6851
Mailing Address - Fax:913-262-8939
Practice Address - Street 1:6310 LAMAR AVE
Practice Address - Street 2:SUITE 230
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66202-4287
Practice Address - Country:US
Practice Address - Phone:913-262-6851
Practice Address - Fax:913-262-8939
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO20001728891835P1300X
KS1-129421835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric