Provider Demographics
NPI:1417057928
Name:GRAYBILL, KAREN L (CRNA)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:L
Last Name:GRAYBILL
Suffix:
Gender:F
Credentials:CRNA
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Other - Credentials:
Mailing Address - Street 1:1209 NW NORTH RIDGE DR STE B
Mailing Address - Street 2:ANESTHESIA SERVICES OF BLUE SPRINGS
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64015-6320
Mailing Address - Country:US
Mailing Address - Phone:816-988-8415
Mailing Address - Fax:816-988-8395
Practice Address - Street 1:1209 NW NORTH RIDGE DR STE B
Practice Address - Street 2:ANESTHESIA SERVICES OF BLUE SPRINGS
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64015-6320
Practice Address - Country:US
Practice Address - Phone:816-988-8415
Practice Address - Fax:816-988-8395
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO109874367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO916781057Medicaid
430066115Medicare PIN
MOS557894Medicare PIN
MOP00297128Medicare PIN