Individual
LEAH ANNA BRANTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1515 S CLIFTON AVE STE 400, WICHITA, KS 67218-2961
(316) 636-1550
(316) 796-7999
Mailing address
PO BOX 8035, WICHITA, KS 67208-0035
(316) 689-9135
(316) 689-9667
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
04-32182
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003719126
MEDICARE
—
05
—
200417800E
—
KS
Enumeration date
12/19/2006
Last updated
07/31/2019
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