Organization
HEARTLAND ANESTHESIA
Active
Other names
HEARTLAND ANESTHESIA , L.L.C.
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY GORDON CRNA (OWNER/PRESIDENT)
(913) 522-0889
Entity
Organization
Contact information
Practice address
711 MARSHALL ST, LEAVENWORTH, KS 66048-3235
(913) 684-1100
(913) 684-1239
Mailing address
PO BOX 410272, KANSAS CITY, MO 64141-0272
(913) 234-1350
(913) 234-1108
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1881998110
—
MO
05
—
200689230A
—
KS
01
—
DR1786
RR MEDICARE
KS
Enumeration date
12/30/2010
Last updated
07/21/2022
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