Individual
AMANDA PHAM PAULSGROVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3901 RAINBOW BLVD, KANSAS CITY, KS 66160
(913) 588-6670
Mailing address
2541 TRACY AVE, KANSAS CITY, MO 64108-2937
(405) 496-6848
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
43-557595-061
KS
Other
Enumeration date
05/20/2018
Last updated
03/13/2019
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