Individual
EDITH A PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
250 NE MULBERRY ST STE 202, SJS MEDICAL MANAGEMENT, LEES SUMMIT, MO 64086-4533
(816) 389-4130
(816) 389-4140
Mailing address
250 NE MULBERRY ST STE 202, SJS MEDICAL MANAGEMENT, LEES SUMMIT, MO 64086-4533
(816) 389-4130
(816) 389-4140
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
056282
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
912919768
—
MO
Enumeration date
09/24/2006
Last updated
04/23/2008
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