Healthcare Provider Details

I. General information

NPI: 1578044988
Provider Name (Legal Business Name): WILLIAM ALAN COHEN CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2018
Last Update Date: 07/18/2024
Certification Date: 07/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6815 FRONTAGE RD
MERRIAM KS
66204-1398
US

IV. Provider business mailing address

5101 COLLEGE BLVD
LEAWOOD KS
66211-1614
US

V. Phone/Fax

Practice location:
  • Phone: 816-478-4200
  • Fax:
Mailing address:
  • Phone: 816-478-4200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number2019012963
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number145775
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: