Basic Information
Provider Information
NPI: 1144752767
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WALDRON
FirstName: ERIN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8717 W 110TH ST
Address2: SUITE 600
City: OVERLAND PARK
State: KS
PostalCode: 662102144
CountryCode: US
TelephoneNumber: 9134282900
FaxNumber: 9134282951
Practice Location
Address1: 19600 E 39TH ST S
Address2:  
City: INDEPENDENCE
State: MO
PostalCode: 640572301
CountryCode: US
TelephoneNumber: 9134282900
FaxNumber: 9134282951
Other Information
ProviderEnumerationDate: 04/02/2017
LastUpdateDate: 02/02/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X2010021381MON Nursing Service ProvidersRegistered Nurse 
367500000X2017015823MOY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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