Healthcare Provider Details

I. General information

NPI: 1346167657
Provider Name (Legal Business Name): ALEXIS DANIELLE RUEGER CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20333 W 151ST ST
OLATHE KS
66061-5350
US

IV. Provider business mailing address

7590 LEGLER ST
SHAWNEE KS
66217-3023
US

V. Phone/Fax

Practice location:
  • Phone: 913-445-4200
  • Fax:
Mailing address:
  • Phone: 913-904-4476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number43-558400-122
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: