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General NPI Number Information
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NPI Number | 1346212586
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Entity Type | Individual
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Provider Name | MARY E WINTER CRNA
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Gender | Female
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Dates
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Enumeration Date | 02/02/2006
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Last Update Date | 10/20/2008
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Provider Practice Location Address
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Address Line | 4510 FREDERICK AVE
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City | SAINT JOSEPH
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State | MO
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Zip | 64506-3238
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Country | US
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Telephone | 816-364-9992
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Fax |
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Provider Business Mailing Address
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Address Line | 3705 N 139TH ST
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City | KANSAS CITY
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State | KS
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Zip | 66109-4234
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Country | US
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Telephone | 913-721-3641
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Fax | 913-721-3649
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 105850
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License Number State | MO
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