Individual
MARY LEAHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
731 N MCLEAN BLVD, WICHITA, KS 67203-4986
(316) 946-5958
Mailing address
1351 PECANWOOD RD, GODDARD, KS 67052-8434
(316) 644-3945
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
54053
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100245940B
—
KS
Enumeration date
08/09/2006
Last updated
06/21/2013
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