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General NPI Number Information
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NPI Number | 1285250019
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Entity Type | Individual
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Provider Name | LEAH ANNE JENSEN MD
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Gender | Female
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Dates
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Enumeration Date | 06/17/2020
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Last Update Date | 01/30/2026
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Provider Practice Location Address
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Address Line | 510 S KINGSHIGHWAY BLVD
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City | SAINT LOUIS
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State | MO
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Zip | 63110-1076
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Country | US
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Telephone | 562-544-2066
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Fax |
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Provider Business Mailing Address
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Address Line | 510 S KINGSHIGHWAY BLVD
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City | SAINT LOUIS
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State | MO
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Zip | 63110-1076
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Country | US
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Telephone | 562-544-2066
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 2022009962
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 2022009962
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 2020017734
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License Number State | MO
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