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NPI Code Detail

MEDICARE: LITHENA L. SKRDLA-VAN DUSEN CRNA

MEDICARE: LITHENA L. SKRDLA-VAN DUSEN CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse Anesthetist100938NE
2367500000XCertified Registered Nurse Anesthetist2007028642MO

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3P00299865OTHERNERR MEDICARE
4P00612249OTHERRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1248478OTHERNEMIDLANDS CHOICE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1659357044
Entity Type Code : Individual
Provider Name (Legal Business Name) : LITHENA L. SKRDLA-VAN DUSEN CRNA
Provider Business Mailing Address
First Line : 2700 CLAY EDWARDS DR STE 240
Second Line :
City : NORTH KANSAS CITY
State : MO
Zip : 64116-3254
Country : US
Telephone Number : 816-691-2021
Fax Number : 816-346-7690
Provider Business Practice Location Address
First Line : 2700 CLAY EDWARDS DR STE 240
Second Line :
City : NORTH KANSAS CITY
State : MO
Zip : 64116-3254
Country : US
Telephone Number : 816-691-2021
Fax Number : 816-346-7690
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2005
Last Update Date : 12/14/2019

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1588761035 — MR. PAUL ALAN LONG CRNA
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Directions to “ LITHENA L. SKRDLA-VAN DUSEN CRNA” Practice Location

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