Individual
MARY PERDUE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
4401 WORNALL RD, ANESTHESIA DEPT, KANSAS CITY, MO 64111-3220
(816) 389-6030
(816) 389-6034
Mailing address
9233 WARD PKWY, SUITE 230, KANSAS CITY, MO 64114-3366
(816) 389-6030
(816) 389-6034
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
062329
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17977069
MO BCBS NUMBER
MO
Enumeration date
05/18/2006
Last updated
07/09/2007
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