MEDICARE: MR. BRADLEY S WILBER RN, BSN,MS, CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	14-594413-051	KS
2	163W00000X	Registered Nurse	63533	NE
3	367500000X	Certified Registered Nurse Anesthetist	2012037456	MO
4	367500000X	Certified Registered Nurse Anesthetist	43-556966	KS

General Provider Information

NPI Number	:	1427387745
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BRADLEY S WILBER RN, BSN,MS, CRNA

Provider Business Mailing Address
First Line	:	29800 W 127TH ST STE 100
Second Line	:
City	:	OLATHE
State	:	KS
Zip	:	66061-8636
Country	:	US
Telephone Number	:	913-405-7814
Fax Number	:

Provider Business Practice Location Address
First Line	:	1318 E 104TH ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64131-4504
Country	:	US
Telephone Number	:	816-256-5200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2009
Last Update Date	:	06/19/2025

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