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General NPI Number Information
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NPI Number | 1851010417
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Entity Type | Organization
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Legal Business Name | GI ALLIANCE ANESTHESIA OF MISSOURI
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Dates
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Enumeration Date | 08/25/2022
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Last Update Date | 08/25/2022
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Provider Practice Location Address
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Address Line | 17501 E US HIGHWAY 40 STE 213A
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City | INDEPENDENCE
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State | MO
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Zip | 64055-6445
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Country | US
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Telephone | 816-478-4887
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Fax |
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Provider Business Mailing Address
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Address Line | 550 RESERVE ST STE 560
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City | SOUTHLAKE
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State | TX
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Zip | 76092-1607
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Country | US
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Telephone | 817-402-7526
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Fax |
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Authorized Official
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Title or Position | ANESTHESIA SUPPORT SERVICE COORDINA
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Name | BRANDI WHEELER
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Credential |
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Telephone | 817-402-7526
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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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