Individual
MARY E WINTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
4510 FREDERICK AVE, SAINT JOSEPH, MO 64506-3238
(816) 364-9992
Mailing address
3705 N 139TH ST, KANSAS CITY, KS 66109-4234
(913) 721-3641
(913) 721-3649
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
105850
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10001883400
COMMUNITY HEALTH PLAN
MO
05
—
100249390F
—
KS
01
—
145390
BLUE CROSS BLUE SHIELD KANSAS
KS
01
—
22069048
BLUE CROSS BLUE SHIELD KANSAS CITY
MO
01
—
5759611
FIRST HEALTH
—
01
—
66048A016
TRICARE WPS
—
05
—
912669439
—
MO
01
—
P00365463
RAILROAD MEDICARE
MO
01
—
P00410954
RAILROAD MEDICARE
KS
Enumeration date
02/02/2006
Last updated
10/20/2008
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