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JEFFREY TYLER CARROLL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
2700 CLAY EDWARDS DR STE 240, NORTH KANSAS CITY, MO 64116-3254
(816) 691-2021
(816) 346-7690
Mailing address
2700 CLAY EDWARDS DR STE 240, NORTH KANSAS CITY, MO 64116-3254
(816) 691-2021
(816) 346-7690

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2009002366
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
2015018286
MO

Other

Enumeration date
04/29/2015
Last updated
10/05/2022
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