Basic Information
Provider Information
NPI: 1437372430
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DUMEY
FirstName: ELIZABETH
MiddleName: ANN
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 801143
Address2:  
City: KANSAS CITY
State: MO
PostalCode: 641801143
CountryCode: US
TelephoneNumber: 5733315583
FaxNumber: 5733315079
Practice Location
Address1: 211 SAINT FRANCIS DR
Address2:  
City: CAPE GIRARDEAU
State: MO
PostalCode: 637035049
CountryCode: US
TelephoneNumber: 5733315150
FaxNumber: 5733315026
Other Information
ProviderEnumerationDate: 04/10/2007
LastUpdateDate: 03/05/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/05/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000X080114MOY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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