Individual
JENNIFER L LEEPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
124 COMMODORE ST, STE B, PRATT, KS 67124-2993
(620) 672-6454
Mailing address
124 COMMODORE ST, STE B, PRATT, KS 67124-2993
(620) 672-6454
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
T-01537
KS
363AS0400X
Surgical Physician Assistant
Primary
1501224
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200477850B
—
KS
Enumeration date
08/30/2007
Last updated
10/01/2014
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