Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kaley Irene Dittemore

Individual provider Certified Registered Nurse Anesthetist · NPI 1790633493

Kaley Irene Dittemore is a Certified Registered Nurse Anesthetist (CRNA) in Saint Joseph, Missouri. Licensed in Missouri. Registered with an NPI since 2026.

Licensed in
MO
In the registry since
2026
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Practice location Address checks out

5325 Faraon St
Saint Joseph, MO 64506-3488
Phone: (816) 271-6000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 2026022471 (MO)

Record details

NPI number1790633493
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMarch 18, 2026
Last updated in NPPESJune 12, 2026
Certification dateJune 12, 2026
Mailing address5325 Faraon St, Saint Joseph, MO 64506-3488

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2026 (0 years in practice)
Accepts Medicare assignment Not indicated

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