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Individual

TERRY KEITH BLUE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1108 E WATERVIEW DR, ANDOVER, KS 67002-7996
(316) 425-8153
(316) 425-8153
Mailing address
1108 E WATERVIEW DR, ANDOVER, KS 67002-7996
(316) 425-8153
(316) 425-8153

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP3243142
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100252100A
KS
05
430056874
FL
Enumeration date
11/16/2005
Last updated
10/13/2011
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