Provider Demographics
NPI:1689856510
Name:LEUENBERGER, KAREN ELAINE (PAC)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:ELAINE
Last Name:LEUENBERGER
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:MISS
Other - First Name:KAREN
Other - Middle Name:ELAINE
Other - Last Name:OWENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:3515 BROADWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-2501
Mailing Address - Country:US
Mailing Address - Phone:816-753-5144
Mailing Address - Fax:816-241-5830
Practice Address - Street 1:4601 INDEPENDENCE AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64124
Practice Address - Country:US
Practice Address - Phone:816-241-6334
Practice Address - Fax:816-241-5830
Is Sole Proprietor?:No
Enumeration Date:2007-12-03
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008033257363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical