Provider Demographics
NPI:1285996009
Name:ONDAK, ANNE MARIE (CRNA)
Entity type:Individual
Prefix:
First Name:ANNE MARIE
Middle Name:
Last Name:ONDAK
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 NE SHOREVIEW CT
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64064-1512
Mailing Address - Country:US
Mailing Address - Phone:816-509-6280
Mailing Address - Fax:
Practice Address - Street 1:103 NE SHOREVIEW CT
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64064-1512
Practice Address - Country:US
Practice Address - Phone:816-509-6280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-08
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO122020163W00000X
MO2012018405367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse