Basic Information
Provider Information
NPI: 1144663576
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FLOODMAN
FirstName: ERICA
MiddleName: ANN
NamePrefix: MRS.
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8717 W 110TH ST
Address2:  
City: OVERLAND PARK
State: KS
PostalCode: 662102144
CountryCode: US
TelephoneNumber: 9134282900
FaxNumber:  
Practice Location
Address1: 10500 QUIVIRA RD
Address2:  
City: OVERLAND PARK
State: KS
PostalCode: 662152306
CountryCode: US
TelephoneNumber: 9134282900
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/16/2013
LastUpdateDate: 06/11/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000X43-557166-071KSY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


Home