Individual
KELSEY WYKOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2301 HOLMES ST, KANSAS CITY, MO 64108-2640
(816) 404-1100
Mailing address
2301 HOLMES ST, KANSAS CITY, MO 64108-2640
(816) 404-1100
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
14-104309-061
KS
163W00000X
Registered Nurse
2007022222
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
2015018024
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
910022528
—
MO
Enumeration date
04/15/2015
Last updated
12/23/2020
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