Individual
MR. KENNETH JUDE CONDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4510 FREDERICK AVE, SAINT JOSEPH, MO 64506-3238
(816) 364-9992
Mailing address
1701 S 45TH ST, SUITE A, KANSAS CITY, KS 66106-2527
(913) 721-3641
(913) 721-3649
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
154996
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10001878100
COMMUNITY HEALTH PLAN
MO
05
—
100352140F
—
KS
01
—
145374
BLUE CROSS BLUE SHIELD KANSAS
KS
01
—
16274
PREFERRED HEALTH SYSTEMS
KS
01
—
26162079
BLUE CROSS BLUE SHIELD KANSAS CITY
MO
05
—
914815543
—
MO
01
—
P00365479
RAILROAD MEDICARE
MO
01
—
P00402322
RAILROAD MEDICARE
KS
Enumeration date
08/02/2006
Last updated
09/10/2015
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