MEDICARE: ALICE K. CHERRY 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	367500000X	Certified Registered Nurse Anesthetist	072705	MO
2	367500000X	Certified Registered Nurse Anesthetist	55031	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659355683
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICE K. CHERRY CRNA

Provider Business Mailing Address
First Line	:	DEPT OF ANESTHESIOLOGY
Second Line	:	3901 RAINBOW BLVD MS 3021
City	:	KANSAS CITY
State	:	KS
Zip	:	66160-0001
Country	:	US
Telephone Number	:	913-588-6670
Fax Number	:	913-588-3365

Provider Business Practice Location Address
First Line	:	DEPT OF ANESTHESIOLOGY
Second Line	:	3901 RAINBOW BLVD MS 3021
City	:	KANSAS CITY
State	:	KS
Zip	:	66160-0001
Country	:	US
Telephone Number	:	913-588-6670
Fax Number	:	913-588-3365

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

Provider Enumeration Date	:	12/02/2005
Last Update Date	:	09/20/2011

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Directions to “ ALICE K. CHERRY CRNA” Practice Location

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