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NPI Code Detail

MEDICARE: ANDREA CANNITO CRNA

MEDICARE: ANDREA CANNITO 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
1163W00000XRegistered Nurse2019023862MO
2367500000XCertified Registered Nurse Anesthetist2026028224MO

General Provider Information

NPI Number : 1619824653
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA CANNITO CRNA
Provider Business Mailing Address
First Line : PO BOX 22407
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63126-0407
Country : US
Telephone Number : 636-386-7222
Fax Number : 636-386-7810
Provider Business Practice Location Address
First Line : 10010 KENNERLY RD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63128-2106
Country : US
Telephone Number : 314-525-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/10/2026
Last Update Date : 06/25/2026

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Directions to “ ANDREA CANNITO CRNA” Practice Location

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