Individual
CODY LEE HAERTHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
664 GREER AVE, NIXA, MO 65714-7637
(818) 421-0683
Mailing address
PO BOX 802843, KANSAS CITY, MO 64180-2843
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
144380
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
910125759
—
MO
Enumeration date
07/18/2022
Last updated
07/18/2023
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