Provider Demographics
NPI:1558463711
Name:VERBANIC, KATHRYN (CRNA)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:
Last Name:VERBANIC
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:KATHRYN
Other - Last Name:MARKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3901 RAINBOW BLVD
Mailing Address - Street 2:4070 DELP MAIL STOP 4017
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160
Mailing Address - Country:US
Mailing Address - Phone:913-588-6670
Mailing Address - Fax:913-588-3365
Practice Address - Street 1:3901 RAINBOW BLVD
Practice Address - Street 2:MAIL STOP 1034
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160
Practice Address - Country:US
Practice Address - Phone:913-588-6670
Practice Address - Fax:913-588-3365
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS54186367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS913746103Medicaid
MO18325023OtherBCBS KANSAS CITY
KS100244600AMedicaid