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General NPI Number Information
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NPI Number | 1588838841
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Entity Type | Individual
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Provider Name | LEENU MISHRA MD
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Gender | Female
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Dates
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Enumeration Date | 04/17/2008
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Last Update Date | 02/09/2010
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Provider Practice Location Address
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Address Line | 700 EAST UNIVERSITY AVE 3 WEST BLANK CHILDRENS PSYCHIATRY
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City | DES MOINES
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State | IA
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Zip | 50316
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Country | US
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Telephone | 515-263-5153
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Fax |
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Provider Business Mailing Address
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Address Line | 5613 VISTA DR
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City | WEST DES MOINES
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State | IA
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Zip | 50266-7222
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Country | US
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Telephone | 515-422-8067
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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 | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 38426
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License Number State | IA
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