Healthcare Provider Details

I. General information

NPI: 1982650784
Provider Name (Legal Business Name): BRENDA SUE KUTTERER CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRENDA SUE MCCRARY

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 02/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8101 W 135TH ST SUITE 200
OVERLAND PARK KS
66223-1111
US

IV. Provider business mailing address

7800 COLLEGE BLVD SUITE 200
OVERLAND PARK KS
66210-1992
US

V. Phone/Fax

Practice location:
  • Phone: 913-491-3999
  • Fax: 913-491-9309
Mailing address:
  • Phone: 913-491-3999
  • Fax: 913-491-9309

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number083335
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number14-61682-011
License Number StateKS
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAP130836
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: