Healthcare Provider Details

I. General information

NPI: 1669671707
Provider Name (Legal Business Name): CHRISTI LORRAINE LEACH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. CHRISTI LORRAINE LAUDENSCHLAGER

II. Dates (important events)

Enumeration Date: 07/17/2007
Last Update Date: 07/21/2022
Certification Date: 05/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 S CLIFTON AVE STE 300
WICHITA KS
67218-2953
US

IV. Provider business mailing address

2200 SW GAGE BLVD
TOPEKA KS
66622-0001
US

V. Phone/Fax

Practice location:
  • Phone: 316-858-0550
  • Fax: 316-858-0596
Mailing address:
  • Phone: 785-350-3111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME114988
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License NumberME114988
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number04-39966
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: