Basic Information
Provider Information
NPI: 1134664428
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHEPMANN
FirstName: LEAH
MiddleName: MICHELLE WILSON
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: WILSON
OtherFirstName: LEAH
OtherMiddleName: MICHELLE
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 3901 RAINBOW BLVD
Address2:  
City: KANSAS CITY
State: KS
PostalCode: 661608500
CountryCode: US
TelephoneNumber: 9135885000
FaxNumber:  
Practice Location
Address1: 3901 RAINBOW BLVD
Address2:  
City: KANSAS CITY
State: KS
PostalCode: 661608500
CountryCode: US
TelephoneNumber: 9135885000
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/22/2016
LastUpdateDate: 12/22/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X53-77490-072KSY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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