Individual
JASON DEAN LIGHTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
5325 FARAON ST, SAINT JOSEPH, MO 64506-3488
(816) 271-6350
(816) 271-6753
Mailing address
PO BOX 410245, KANSAS CITY, MO 64141-0245
(816) 271-1365
(816) 271-6753
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2012018728
MO
Other
Enumeration date
07/09/2012
Last updated
10/09/2024
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