Draves-Wagner, Tonya L

Draves-Wagner, Tonya L is an individual health care provider with primary practice located at 525 Couch Ave , St. Louis MO 63122. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Draves-Wagner, Tonya L can be contacted via phone (314) 966-1500.

Contact Information

Primary practice address
525 Couch Ave St. Louis MO 63122
Phone: (314) 966-1500
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 2003021073 Missouri

Profile Details

NPI number 1629269337
LBN Legal business name Draves-Wagner, Tonya L
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 7th, 2007
Last updated May 2nd, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629269337 NPPES
Missouri MEDICAID 916300908

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