Individual
TERESA A. EDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
9100 W 74TH ST, SHAWNEE MISSION, KS 66204-4004
(913) 676-2679
(913) 789-3191
Mailing address
6938 CHARLOTTE ST, SHAWNEE, KS 66216-3925
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
13-81196-032
KS
367500000X
Certified Registered Nurse Anesthetist
Primary
556971
KS
Other
Enumeration date
04/16/2010
Last updated
07/08/2010
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