Basic Information
Provider Information
NPI: 1285002139
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LEONARD
FirstName: LAUREN
MiddleName: KELSEY
NamePrefix: DR.
NameSuffix:  
Credential: PHARM.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1055 CLERMONT ST # 119
Address2:  
City: DENVER
State: CO
PostalCode: 802203808
CountryCode: US
TelephoneNumber: 5738641704
FaxNumber: 3033707506
Practice Location
Address1: 1055 CLERMONT ST
Address2:  
City: DENVER
State: CO
PostalCode: 802203808
CountryCode: US
TelephoneNumber: 5738641704
FaxNumber: 3033707506
Other Information
ProviderEnumerationDate: 09/09/2015
LastUpdateDate: 09/09/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
183500000X2015029219MOY Pharmacy Service ProvidersPharmacist 

No ID Information.


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