Individual
JOSHUA MUTTAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
823 SW MULVANE ST STE 210, TOPEKA, KS 66606-1679
(785) 235-3451
(785) 235-1435
Mailing address
4916 WOODSONIA DR, SHAWNEE, KS 66226-3831
(913) 710-2909
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
99751
KS
207L00000X
Anesthesiology Physician
43-558040-102
KS
367500000X
Certified Registered Nurse Anesthetist
Primary
43558040102
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
43-558040-102
CRNA
KS
Enumeration date
06/09/2022
Last updated
05/08/2023
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