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Individual

MARY ALLISON WETZEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
603 E GAINES DR, CLINTON, MO 64735-3205
(660) 885-8141
(660) 885-5815
Mailing address
901 E. 104TH ST., MAILSTOP 400N, KANSAS CITY, MO 64131
(816) 502-7104
(816) 932-9670

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
129500
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
129500
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
916844301
MO
Enumeration date
01/15/2007
Last updated
02/08/2018
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