Organization
KENNETT HMA PHYSICIAN MANAGEMENT, INC.
Active
Other names
Kennett Anesthesia Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MICHELLE M BEACHAM (CONTROLLER)
(573) 888-8424
Entity
Organization
Contact information
Practice address
1301 1ST ST, KENNETT, MO 63857-2525
(573) 888-8424
(573) 888-2715
Mailing address
1231 1ST ST, SUITE 8, KENNETT, MO 63857-2527
(573) 888-8424
(573) 888-2715
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500451901
—
MO
Enumeration date
11/19/2008
Last updated
11/19/2008
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