Provider Demographics
NPI:1174897466
Name:CARNEAL, LESLEE ELLEN (RNFNP)
Entity type:Individual
Prefix:MRS
First Name:LESLEE
Middle Name:ELLEN
Last Name:CARNEAL
Suffix:
Gender:F
Credentials:RNFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 CAMBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-6405
Mailing Address - Country:US
Mailing Address - Phone:913-588-1227
Mailing Address - Fax:
Practice Address - Street 1:4000 CAMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-2507
Practice Address - Country:US
Practice Address - Phone:913-588-1227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-04
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS75962363L00000X
MO2012006267363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO177089466Medicaid
MO200975630AMedicaid
KS200975630BMedicaid
MOP01193398OtherRR MEDICARE
MO200975630AMedicaid
MO701000178Medicare PIN