Provider Demographics
NPI:1467488429
Name:GREEN, ANDREW J (CRNA)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:J
Last Name:GREEN
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Gender:M
Credentials:CRNA
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Mailing Address - Street 1:9233 WARD PKWY
Mailing Address - Street 2:SUITE 230
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-3366
Mailing Address - Country:US
Mailing Address - Phone:816-389-6030
Mailing Address - Fax:816-389-6034
Practice Address - Street 1:12300 METCALF AVE
Practice Address - Street 2:ANESTHESIA DEPT
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-1324
Practice Address - Country:US
Practice Address - Phone:816-389-6030
Practice Address - Fax:816-389-6034
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
KS55514367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered