Provider Demographics
NPI:1699358184
Name:ADAIR, KAITLIN COLLEEN (CRNA)
Entity Type:Individual
Prefix:
First Name:KAITLIN
Middle Name:COLLEEN
Last Name:ADAIR
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:KAITLIN
Other - Middle Name:COLLEEN
Other - Last Name:GAMSO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:660 W. 70TH STREET
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64113
Mailing Address - Country:US
Mailing Address - Phone:816-728-9820
Mailing Address - Fax:
Practice Address - Street 1:15534 COLLEGE BLVD
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66219
Practice Address - Country:US
Practice Address - Phone:816-766-8827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-03
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021019486367500000X
IL209-025015367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered