MEDICARE: MS. CHERYL ANN THURMAN CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	077810	MO
2	207L00000X	Anesthesiology Physician	077810034175	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316977101
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHERYL ANN THURMAN CRNA

Provider Business Mailing Address
First Line	:	2315 DOUGHERTY FERRY RD
Second Line	:	SUITE 107
City	:	ST. LOUIS
State	:	MO
Zip	:	63122-3383
Country	:	US
Telephone Number	:	314-966-7570
Fax Number	:	314-966-7788

Provider Business Practice Location Address
First Line	:	2315 DOUGHERTY FERRY RD
Second Line	:	SUITE 107
City	:	ST. LOUIS
State	:	MO
Zip	:	63122-3383
Country	:	US
Telephone Number	:	314-966-7570
Fax Number	:	314-966-7788

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/04/2006
Last Update Date	:	06/21/2012

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