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NPI Code Detail

MEDICARE: TRUDY A. DONNELLY CRNA

MEDICARE:   TRUDY A. DONNELLY  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 Anesthetist54356KS
2367500000XCertified Registered Nurse Anesthetist115730MO

Other Identifiers

General Provider Information

NPI Number : 1891770418
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRUDY A. DONNELLY CRNA
Provider Business Mailing Address
First Line : PO BOX 411851
Second Line :
City : KANSAS CITY
State : MO
Zip : 64141-1851
Country : US
Telephone Number : 913-588-6670
Fax Number : 913-588-3365
Provider Business Practice Location Address
First Line : 3901 RAINBOW BLVD
Second Line :
City : KANSAS CITY
State : KS
Zip : 66160-8500
Country : US
Telephone Number : 913-588-6670
Fax Number : 913-588-3365
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/07/2005
Last Update Date : 08/15/2014

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Directions to “ TRUDY A. DONNELLY CRNA” Practice Location

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