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NPI 1457855116

NPI 1457855116 : MARRIANN DUGAN CRNA, DNP : KANSAS CITY, KS

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General NPI Number Information
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    NPI Number           |    1457855116
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    Entity Type          |    Individual 
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    Provider Name        |    MARRIANN DUGAN CRNA, DNP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/19/2018
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    Last Update Date     |    06/18/2018
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Provider Practice Location Address
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    Address Line         |    4000 CAMBRIDGE ST 
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    City                 |    KANSAS CITY
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    State                |    KS
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    Zip                  |    66160
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    Country              |    US
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    Telephone            |    913-588-1227
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    6403 BLUEJACKET ST 
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    City                 |    SHAWNEE
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    State                |    KS
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    Zip                  |    66203-3545
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    Country              |    US
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    Telephone            |    913-631-7585
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    Fax                  |    
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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        |    390200000X
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    Taxonomy Name        |    Student in an Organized Health Care Education/Training Program
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    License Number       |    390200000X
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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       |    557599
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    License Number State |    KS
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