Healthcare Provider Details

I. General information

NPI: 1891288783
Provider Name (Legal Business Name): SCOTT A KAHRE CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2018
Last Update Date: 07/01/2021
Certification Date: 07/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 S WOODS MILL RD STE 140
CHESTERFIELD MO
63017-3427
US

IV. Provider business mailing address

13515 BARRETT PARKWAY DR STE 170
BALLWIN MO
63021-5870
US

V. Phone/Fax

Practice location:
  • Phone: 314-485-1101
  • Fax: 314-485-1104
Mailing address:
  • Phone: 314-775-2811
  • Fax: 314-775-2816

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number239533
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number2018020174
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: