Individual
JASON A. BOLYARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4401 WORNALL RD, ANESTHESIA DEPT, KANSAS CITY, MO 64111-3220
(816) 389-6030
(816) 389-6034
Mailing address
PO BOX 504407, SAINT LOUIS, MO 63150-4407
(816) 502-7000
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2005029853
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2005029853
LICENSE
MO
01
—
SRNA
STUDENT
—
Enumeration date
02/26/2008
Last updated
08/31/2015
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