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Individual

MRS. TAMARA-JANE HARDING GUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
250 NE MULBERRY ST, C/O SJS MEDICAL MANAGEMENT, SUITE 202, LEES SUMMIT, MO 64086-4533
(816) 389-4130
(816) 389-4140
Mailing address
1009 NE 94TH COURT, KANSAS CITY, MO 64155
(816) 436-4279

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
129913
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
39408094
BCBS KC
MO
05
914603907
MO
01
P02156077
RAILROAD
MO
Enumeration date
05/04/2007
Last updated
10/09/2024
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