Healthcare Provider Details

I. General information

NPI: 1356330781
Provider Name (Legal Business Name): SCOTT A. NAEGER CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

232 S WOODS MILL RD
CHESTERFIELD MO
63017-3417
US

IV. Provider business mailing address

17344 HILLTOP RIDGE DR
EUREKA MO
63025-1036
US

V. Phone/Fax

Practice location:
  • Phone: 314-205-6917
  • Fax:
Mailing address:
  • Phone: 636-938-7348
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number110951
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: