Provider Demographics
NPI:1699843995
Name:ARMISTEAD-JEHLE, PATRICK JON (PHD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:JON
Last Name:ARMISTEAD-JEHLE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:PATRICK
Other - Middle Name:JON
Other - Last Name:JEHLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:550 POPE AVE
Mailing Address - Street 2:MUNSON ARMY HEALTH CENTER/BEHAVIORAL HEALTH
Mailing Address - City:FORT LEAVENWORTH
Mailing Address - State:KS
Mailing Address - Zip Code:66223
Mailing Address - Country:US
Mailing Address - Phone:913-684-6790
Mailing Address - Fax:
Practice Address - Street 1:550 POPE AVE
Practice Address - Street 2:MUNSON ARMY HEALTH CENTER/BEHAVIORAL HEALTH
Practice Address - City:FORT LEAVENWORTH
Practice Address - State:KS
Practice Address - Zip Code:66223
Practice Address - Country:US
Practice Address - Phone:913-684-6790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI949103TC0700X
KS2139103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical