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General NPI Number Information
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NPI Number | 1770275653
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Entity Type | Individual
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Provider Name | JENNA RENAE MILLER RIZZO CRNA
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Gender | Female
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Dates
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Enumeration Date | 05/22/2023
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Last Update Date | 05/22/2023
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Provider Practice Location Address
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Address Line | 2100 SE BLUE PKWY
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City | LEES SUMMIT
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State | MO
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Zip | 64063-1007
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Country | US
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Telephone | 816-282-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 635 E 63RD TER
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City | KANSAS CITY
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State | MO
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Zip | 64110-3337
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Country | US
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Telephone | 316-258-4076
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 143171
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License Number State | MO
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