Provider Demographics
NPI:1184917973
Name:WHISENHUNT, LESLIE JENNY
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:JENNY
Last Name:WHISENHUNT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JENNY
Other - Middle Name:
Other - Last Name:WHISENHUNT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 890070
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73189-0070
Mailing Address - Country:US
Mailing Address - Phone:405-378-2222
Mailing Address - Fax:405-378-2240
Practice Address - Street 1:10400 S WESTERN AVE
Practice Address - Street 2:SUITE 7
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-3016
Practice Address - Country:US
Practice Address - Phone:405-378-2222
Practice Address - Fax:405-378-2240
Is Sole Proprietor?:No
Enumeration Date:2011-05-26
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK20110910363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics