Individual
JOHN R DRIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
806 LAKEHOME LN, CAPE FAIR, MO 65624-5305
(417) 669-9382
Mailing address
806 LAKEHOME LN, CAPE FAIR, MO 65624-5305
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
058819
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
158514001
—
AR
01
—
194111
BCBS
MO
05
—
200089370A
—
OK
01
—
20174319965616B008
TRICARE
MO
01
—
210165
HEALTHLINK
MO
01
—
22941
COX HEALTH
MO
05
—
912834611
—
MO
05
—
912834686
—
MO
01
—
P00217677
RAILROAD
MO
Enumeration date
09/19/2005
Last updated
10/03/2024
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