Individual
PAUL PETERSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
12300 METCALF AVE, ANESTHESIA DEPT, OVERLAND PARK, KS 66213-1324
(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
093647
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
54581
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19059024
BCBS NUMBER
KS
Enumeration date
05/25/2006
Last updated
11/29/2023
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