Provider Demographics
NPI:1184925869
Name:LEOPOLD, JAMIE DIANE (MSN ARNP)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:DIANE
Last Name:LEOPOLD
Suffix:
Gender:F
Credentials:MSN ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 740019
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-0019
Mailing Address - Country:US
Mailing Address - Phone:816-381-5648
Mailing Address - Fax:
Practice Address - Street 1:1634 E 63RD ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64110-3502
Practice Address - Country:US
Practice Address - Phone:816-381-5648
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-11
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008030034363LF0000X
KS53-75231-041363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily