Individual
STACY D. HACKLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
9100 W 74TH ST, SHAWNEE MISSION, KS 66204-4004
(913) 632-2230
(913) 632-2297
Mailing address
PO BOX 411895, KANSAS CITY, MO 64141-1895
(913) 632-2230
(913) 632-2297
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
102393
KS
367500000X
Certified Registered Nurse Anesthetist
Primary
557354
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201117670A
—
KS
01
—
53423014
BCBS KC
KS
01
—
P01556230
RAILROAD
KS
Enumeration date
07/23/2015
Last updated
11/30/2020
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