Provider Demographics
NPI:1770141442
Name:STEPHENSON, LEIGH ELLEN (DNP, APRN, WHNP-BC)
Entity type:Individual
Prefix:DR
First Name:LEIGH
Middle Name:ELLEN
Last Name:STEPHENSON
Suffix:
Gender:F
Credentials:DNP, APRN, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1704 ARCHER DR
Mailing Address - Street 2:
Mailing Address - City:RAYMORE
Mailing Address - State:MO
Mailing Address - Zip Code:64083-7875
Mailing Address - Country:US
Mailing Address - Phone:256-975-2414
Mailing Address - Fax:
Practice Address - Street 1:710 N 7TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66101-3051
Practice Address - Country:US
Practice Address - Phone:913-573-8914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-29
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS78233363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health