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Individual

MARY E O'CONNELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
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
Primary
55153
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200000930A
KS
01
33209017
BCBS NUMBER
KS
05
918782103
KS
01
P00177156
RR MEDICARE NUMBER
KS
Enumeration date
05/26/2006
Last updated
02/12/2008
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