Healthcare Provider Details

I. General information

NPI: 1760593339
Provider Name (Legal Business Name): FRANCES EMIG FISTER CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 11/02/2021
Certification Date: 11/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10010 KENNERLY RD
SAINT LOUIS MO
63128-2106
US

IV. Provider business mailing address

339 CONSORT DR
BALLWIN MO
63011-4439
US

V. Phone/Fax

Practice location:
  • Phone: 636-386-7222
  • Fax: 636-386-7810
Mailing address:
  • Phone: 636-386-7222
  • Fax: 636-386-7810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number086392
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: