Provider Demographics
NPI:1205636156
Name:PRICE, LESLIE SUSAN (CRNA)
Entity type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:SUSAN
Last Name:PRICE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12656 W 105TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66215-2232
Mailing Address - Country:US
Mailing Address - Phone:816-672-9510
Mailing Address - Fax:
Practice Address - Street 1:12656 W 105TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66215-2232
Practice Address - Country:US
Practice Address - Phone:816-672-9510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-18
Last Update Date:2025-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13-115562-032163W00000X
KS43-558289-032367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse