Basic Information
| Provider Information | |||||||||
| NPI: | 1548406291 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | EIMAN | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | B | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5325 FARAON ST | ||||||||
| Address2: | |||||||||
| City: | SAINT JOSEPH | ||||||||
| State: | MO | ||||||||
| PostalCode: | 645063488 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8162711365 | ||||||||
| FaxNumber: | 8162716753 | ||||||||
| Practice Location | |||||||||
| Address1: | 5325 FARAON ST | ||||||||
| Address2: | |||||||||
| City: | SAINT JOSEPH | ||||||||
| State: | MO | ||||||||
| PostalCode: | 645063488 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8162711365 | ||||||||
| FaxNumber: | 8162716753 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/31/2008 | ||||||||
| LastUpdateDate: | 12/31/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | 143602 | MO | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | 163W00000X | 143602 | MO | N | Nursing Service Providers | Registered Nurse |
No ID Information.