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General NPI Number Information
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NPI Number | 1467042317
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Entity Type | Individual
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Provider Name | MS. KAYLA SAGAL
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Gender | Female
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Dates
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Enumeration Date | 01/25/2021
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Last Update Date | 12/13/2023
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Provider Practice Location Address
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Address Line | 1465 S GRAND BLVD
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City | SAINT LOUIS
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State | MO
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Zip | 63104-1003
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Country | US
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Telephone | 314-977-1676
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Fax |
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Provider Business Mailing Address
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Address Line | 1302 S BOYLE AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63110-3816
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Country | US
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Telephone | 715-415-4499
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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 | 2021019696
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 2016004153
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License Number State | MO
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