Healthcare Provider Details

I. General information

NPI: 1770880288
Provider Name (Legal Business Name): CHRISTINA R BAUMGARTNER CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTINA R DAWSON CRNA

II. Dates (important events)

Enumeration Date: 02/17/2011
Last Update Date: 03/28/2025
Certification Date: 03/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 N GRAND BLVD
SAINT LOUIS MO
63106-1621
US

IV. Provider business mailing address

PO BOX 22407
SAINT LOUIS MO
63126-0407
US

V. Phone/Fax

Practice location:
  • Phone: 217-827-4328
  • Fax:
Mailing address:
  • Phone: 636-386-7222
  • Fax: 636-200-4036

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number2011004386
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: