Healthcare Provider Details

I. General information

NPI: 1194920066
Provider Name (Legal Business Name): GUARDIAN ANESTHESIA SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4321 WASHINGTON ST
KANSAS CITY MO
64111-5961
US

IV. Provider business mailing address

PO BOX 413770
KANSAS CITY MO
64141-3770
US

V. Phone/Fax

Practice location:
  • Phone: 913-754-8508
  • Fax: 913-647-0575
Mailing address:
  • Phone: 913-754-8508
  • Fax: 913-647-0575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. ELISA A MCKAY
Title or Position: OWNER
Credential: CRNA
Phone: 913-754-8508