Provider Demographics
NPI:1124065354
Name:LEEPER, JENNIFER ANN (DO)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ANN
Last Name:LEEPER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:ANN
Other - Last Name:BAGALEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:165 MA'A STREET
Mailing Address - Street 2:
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732-3603
Mailing Address - Country:US
Mailing Address - Phone:808-446-7120
Mailing Address - Fax:808-446-7121
Practice Address - Street 1:165 MA'A STREET
Practice Address - Street 2:
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-3603
Practice Address - Country:US
Practice Address - Phone:808-446-7120
Practice Address - Fax:808-446-7121
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDOS-1066207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology