Fundenberger, Timothy D

Fundenberger, Timothy D is an individual health care provider with primary practice located at 1209 Nw North Ridge Dr Ste B Anesthesia Services Of Blue Springs, Blue Springs MO 64015-6320. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Fundenberger, Timothy D can be contacted via phone (816) 988-8415.

Contact Information

Primary practice address
1209 Nw North Ridge Dr Ste B Anesthesia Services Of Blue Springs Blue Springs MO 64015-6320
Phone: (816) 988-8415
Fax: (816) 988-8395
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 131800 Missouri

Profile Details

NPI number 1053412601
LBN Legal business name Fundenberger, Timothy D
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 26th, 2006
Last updated Jan 20th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053412601 NPPES
Missouri MEDICAID 918702523

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