Organization
COLLEGE BOULEVARD ANESTHESIA SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL STEPHEN BENNETTS CRNA (PARTNER ADMINISTRATOR)
(913) 294-2327
Entity
Organization
Contact information
Practice address
2100 BAPTISTE DR, PAOLA, KS 66071
(913) 294-2327
Mailing address
PO BOX 388, NEWTON, KS 67114-0388
(316) 281-3700
(316) 282-4322
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
01/30/2006
Last updated
05/12/2011
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