Provider Demographics
NPI:1912505371
Name:DIMAGGIO, ALEXYS M (CRNA)
Entity Type:Individual
Prefix:
First Name:ALEXYS
Middle Name:M
Last Name:DIMAGGIO
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:ALEXYS
Other - Middle Name:M
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11009 N MATTOX CT
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64154-1831
Mailing Address - Country:US
Mailing Address - Phone:816-803-0080
Mailing Address - Fax:
Practice Address - Street 1:1500 SW 10TH AVE
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66604-1301
Practice Address - Country:US
Practice Address - Phone:816-803-0080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-16
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-136503-041163W00000X
MO43-557836-041367500000X
KS43-557836-041367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse