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General NPI Number Information
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NPI Number | 1699570804
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Entity Type | Individual
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Provider Name | LEAH M CREDLE RN, BSN
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Gender | Female
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Dates
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Enumeration Date | 02/13/2025
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Last Update Date | 02/13/2025
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Provider Practice Location Address
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Address Line | 4801 E LINWOOD BLVD
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City | KANSAS CITY
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State | MO
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Zip | 64128-2226
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Country | US
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Telephone | 816-861-4700
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Fax |
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Provider Business Mailing Address
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Address Line | 5525 N FLINT RIDGE RD
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City | KANSAS CITY
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State | MO
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Zip | 64151-3449
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Country | US
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Telephone | 816-729-2536
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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 | 163WX0200X
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Taxonomy Name | Oncology Registered Nurse
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License Number | 2012002250
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License Number State | MO
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