Healthcare Provider Details

I. General information

NPI: 1851323802
Provider Name (Legal Business Name): MICHELLE MARIE HAINES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 WORNALL RD ANESTHESIA DEPT
KANSAS CITY MO
64111-3220
US

IV. Provider business mailing address

PO BOX 504404
SAINT LOUIS MO
63150-4404
US

V. Phone/Fax

Practice location:
  • Phone: 816-932-7940
  • Fax: 816-932-7957
Mailing address:
  • Phone: 816-932-7940
  • Fax: 816-932-7957

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number2005004470
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number103118
License Number StateWI
# 3
Primary TaxonomyY
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number2005004470
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: