Provider Demographics
NPI:1740611789
Name:GUARDIAN ANESTHESIA SPECIALISTS, LLC
Entity Type:Organization
Organization Name:GUARDIAN ANESTHESIA SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ELISA
Authorized Official - Middle Name:A
Authorized Official - Last Name:MCKAY
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:913-262-2277
Mailing Address - Street 1:PO BOX 413186
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64141-3186
Mailing Address - Country:US
Mailing Address - Phone:888-243-4478
Mailing Address - Fax:913-647-0575
Practice Address - Street 1:5151 NW 88TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64154-2700
Practice Address - Country:US
Practice Address - Phone:816-420-3939
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-02
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO207L00000X
MO078933367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty