Provider Demographics
NPI:1801127014
Name:MEAD, JENNIFER LEIGH (ND)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:LEIGH
Last Name:MEAD
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5025 E KELLOGG DR STE 108
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67218-1504
Mailing Address - Country:US
Mailing Address - Phone:316-573-1330
Mailing Address - Fax:316-799-8796
Practice Address - Street 1:5025 E KELLOGG DR STE 108
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67218-1504
Practice Address - Country:US
Practice Address - Phone:316-573-1330
Practice Address - Fax:316-799-8796
Is Sole Proprietor?:No
Enumeration Date:2010-01-28
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS21-00027175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath