Individual
MELISSA ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
4401 WORNALL RD, KANSAS CITY, MO 64111-3220
(816) 932-7940
Mailing address
901 E 104TH ST, MS 400S, KANSAS CITY, MO 64131-4517
(816) 599-9499
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2005000117
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
2014020765
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2014020765
LICENSE
MO
05
—
910014783
—
MO
Enumeration date
04/19/2014
Last updated
12/02/2020
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