Healthcare Provider Details

I. General information

NPI: 1265566376
Provider Name (Legal Business Name): ANGELA FRITSCHLE CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

351 CONSORT DR
BALLWIN MO
63011-4439
US

IV. Provider business mailing address

17298 N OUTER 40 RD STE 200
CHESTERFIELD MO
63005-1456
US

V. Phone/Fax

Practice location:
  • Phone: 636-200-4242
  • Fax:
Mailing address:
  • Phone: 314-529-4900
  • Fax: 314-434-2679

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number2007001238
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: