Healthcare Provider Details

I. General information

NPI: 1235294216
Provider Name (Legal Business Name): CHRISTITA S WEBER CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 03/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6910 GLEASON RD
SHAWNEE KS
66226-3548
US

IV. Provider business mailing address

6910 GLEASON RD
SHAWNEE KS
66226-3548
US

V. Phone/Fax

Practice location:
  • Phone: 913-579-5101
  • Fax:
Mailing address:
  • Phone: 913-579-5101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number54309
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: