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NPI Code Detail

MEDICARE: MS. AIDA G LAWRENCE CRNA

MEDICARE: MS. AIDA G LAWRENCE 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
1367500000XCertified Registered Nurse Anesthetist1999140166MO

General Provider Information

NPI Number : 1831142991
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. AIDA G LAWRENCE CRNA
Provider Business Mailing Address
First Line : 615 W NURSERY ST
Second Line :
City : BUTLER
State : MO
Zip : 64730-1840
Country : US
Telephone Number : 660-200-7000
Fax Number : 660-200-7015
Provider Business Practice Location Address
First Line : 615 W NURSERY ST
Second Line :
City : BUTLER
State : MO
Zip : 64730-1840
Country : US
Telephone Number : 660-200-7000
Fax Number : 660-200-7015
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2006
Last Update Date : 07/08/2007

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