Provider Demographics
NPI:1427659317
Name:WEBB, LESLEY SHANNON (PHARMD)
Entity type:Individual
Prefix:
First Name:LESLEY
Middle Name:SHANNON
Last Name:WEBB
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11714 OAKLEY AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64137-2716
Mailing Address - Country:US
Mailing Address - Phone:440-552-0408
Mailing Address - Fax:
Practice Address - Street 1:4300 RAINBOW BLVD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66103-3425
Practice Address - Country:US
Practice Address - Phone:913-403-0581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-05
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-109036183500000X
MO2020020849183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist