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General NPI Number Information
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NPI Number | 1568466043
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Entity Type | Individual
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Provider Name | KURT D LEIS ARNP
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Gender | Male
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Dates
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Enumeration Date | 06/13/2005
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Last Update Date | 12/03/2007
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Provider Practice Location Address
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Address Line | 1001 N MINNEAPOLIS
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City | WICHITA
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State | KS
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Zip | 67214-3124
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Country | US
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Telephone | 316-293-2647
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Fax | 316-293-1863
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Provider Business Mailing Address
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Address Line | 1010 N KANSAS SUITE 3049
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City | WICHITA
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State | KS
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Zip | 67214-3199
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Country | US
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Telephone | 316-293-2647
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Fax | 316-293-1863
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 74826
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License Number State | KS
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