Most Relevant Information
Provider Data
| NPI Number: | 1003220633 |
| Provider Name: | AUSTIN BOONE MCCLURE CRNA |
| Entity Type: | Individual |
| Taxonomy Code: | 367500000X |
| Specialty: | Nurse Anesthetist, Certified Registered |
| License Number: | 2014017971 |
Most Important Dates
| Enumeration Date: | 06/11/2014 |
| Last Updated: | 07/02/2014 |
Provider Practice Location
1102 W 32ND ST
JOPLIN
MO
648043503
Practice Location Phone/Fax
| Phone: | 4173471078 |
| Fax: | 4173471079 |
Provider Mailing Location
1102 W 32ND ST
JOPLIN
MO
648043503
Provider Mailing Phone/Fax
| Phone: | 4173471078 |
| Fax: | 4173471079 |