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General NPI Number Information
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NPI Number | 1124103205
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Entity Type | Organization
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Legal Business Name | GUARDIAN ANESTHESIA SERVICES
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 10/03/2019
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Provider Practice Location Address
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Address Line | 3840 W 75TH ST
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City | PRAIRIE VILLAGE
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State | KS
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Zip | 66208-4126
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Country | US
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Telephone | 913-384-9600
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Fax | 913-284-9646
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Provider Business Mailing Address
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Address Line | PO BOX 413770
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City | KANSAS CITY
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State | MO
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Zip | 64141-3770
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Country | US
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Telephone | 800-903-2088
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Fax | 913-696-7141
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | ELISA A MCKAY
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Credential | CRNA
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Telephone | 913-262-2277
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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