Individual
STAN D AVERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
100 NE SAINT LUKES BLVD, LEES SUMMIT, MO 64086-6000
(816) 347-5000
(816) 347-5045
Mailing address
10310 STATE LINE RD, SUITE A, LEAWOOD, KS 66206-2658
(913) 647-4100
(913) 647-4120
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
102966
MO
Other
Enumeration date
04/02/2009
Last updated
04/02/2009
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