Individual
LISA M ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
929 N SAINT FRANCIS ST, WICHITA, KS 67214-3821
(316) 268-5000
Mailing address
PO BOX 2897, WICHITA, KS 67201-2897
(800) 374-5326
(800) 374-7656
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1396137051
KS
367500000X
Certified Registered Nurse Anesthetist
139567
KS
367500000X
Certified Registered Nurse Anesthetist
Primary
556899
KS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200622580A
—
KS
Enumeration date
06/02/2009
Last updated
11/05/2009
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