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General NPI Number Information
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NPI Number | 1326438987
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Entity Type | Individual
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Provider Name | ELIZABETH ANN HUGHETT CRNA
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Gender | Female
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Dates
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Enumeration Date | 02/03/2015
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Last Update Date | 02/03/2015
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Provider Practice Location Address
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Address Line | 11133 DUNN RD
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City | SAINT LOUIS
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State | MO
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Zip | 63136-6163
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Country | US
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Telephone | 314-920-6494
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Fax |
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Provider Business Mailing Address
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Address Line | 201 BRAESHIRE DR UNIT E
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City | BALLWIN
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State | MO
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Zip | 63021-5673
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Country | US
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Telephone | 314-920-6494
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 103801
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License Number State | MO
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