Healthcare Provider Details

I. General information

NPI: 1629531124
Provider Name (Legal Business Name): MEGAN M CHAMBERS CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2019
Last Update Date: 10/02/2024
Certification Date: 10/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6420 CLAYTON RD
SAINT LOUIS MO
63117-1811
US

IV. Provider business mailing address

7420 CLAYTON RD.
ST. LOUIS MO
63117
US

V. Phone/Fax

Practice location:
  • Phone: 314-768-8442
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number2019012503
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: