Healthcare Provider Details

I. General information

NPI: 1891999249
Provider Name (Legal Business Name): BRANDI E. HUFFSTUTTER CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2007
Last Update Date: 11/23/2020
Certification Date: 11/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8935 STATE AVE
KANSAS CITY KS
66112-1645
US

IV. Provider business mailing address

35 W 69TH ST
KANSAS CITY MO
64113-2501
US

V. Phone/Fax

Practice location:
  • Phone: 913-334-8935
  • Fax:
Mailing address:
  • Phone: 816-682-8032
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number100390
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: