Provider Demographics
NPI:1649247446
Name:PRICE, VICKI MCCANN (CRNA)
Entity type:Individual
Prefix:MRS
First Name:VICKI
Middle Name:MCCANN
Last Name:PRICE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MS
Other - First Name:VICKI
Other - Middle Name:SUE
Other - Last Name:SIFERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:55 WESTPORT PLAZA
Mailing Address - Street 2:STE 3300
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146-3192
Mailing Address - Country:US
Mailing Address - Phone:314-548-4706
Mailing Address - Fax:314-548-4747
Practice Address - Street 1:8800 BALLANTINE
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66214-1900
Practice Address - Country:US
Practice Address - Phone:913-895-4050
Practice Address - Fax:913-894-0384
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS54588163W00000X
KS1435823111163W00000X
KS4354588111367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse