Provider Demographics
NPI:1508381732
Name:JONES, ALYSSA A (CRNA)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:A
Last Name:JONES
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8717 W 110TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-2144
Mailing Address - Country:US
Mailing Address - Phone:913-428-2940
Mailing Address - Fax:913-428-2951
Practice Address - Street 1:2401 GILLHAM RD
Practice Address - Street 2:ATTN: PROVIDER ENROLLMENT DEPARTMENT
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108-4619
Practice Address - Country:US
Practice Address - Phone:816-701-5200
Practice Address - Fax:816-302-9939
Is Sole Proprietor?:No
Enumeration Date:2017-08-09
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2017017845367500000X
KS557500367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered