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General NPI Number Information
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NPI Number | 1174085765
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Entity Type | Individual
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Provider Name | RACHEL M MITCHELSON CRNA
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Gender | Female
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Dates
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Enumeration Date | 04/02/2019
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Last Update Date | 08/23/2024
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Provider Practice Location Address
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Address Line | 6815 FRONTAGE RD
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City | MERRIAM
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State | KS
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Zip | 66204-1398
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Country | US
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Telephone | 816-478-4200
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Fax | 816-875-2598
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Provider Business Mailing Address
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Address Line | 5101 COLLEGE BLVD
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City | LEAWOOD
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State | KS
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Zip | 66211-1614
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Country | US
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Telephone | 816-478-4200
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Fax | 816-875-2598
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 13-118953-102
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 43-557694-102
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License Number State | KS
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