Individual
LINDSEY BREANNE WILSON
Active
Sole proprietor
No
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
1422 LIMERICK CT, LIBERTY, MO 64068-3396
(816) 678-2040
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2012018727
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
919841502
—
MO
Enumeration date
06/15/2012
Last updated
12/23/2020
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