Mrs Kristen Doherty, AA-C | |
615 S. New Ballas Rd., Dept. Of Anesthesiology, St. Louis, MO 63141 | |
(314) 251-4687 | |
(636) 386-7679 |
Full Name | Mrs Kristen Doherty |
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Gender | Female |
Speciality | Anesthesiologist Assistant |
Location | 615 S. New Ballas Rd., St. Louis, Missouri |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1780005488 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367H00000X | Anesthesiologist Assistant | 2014016080 (Missouri) | Primary |
Entity Name | Western Anesthesiology Associates Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1275646754 PECOS PAC ID: 6204720667 Enrollment ID: O20040226000438 |
Mailing Address | Practice Location Address |
---|---|
Mrs Kristen Doherty, AA-C 339 Consort Dr, Ballwin, MO 63011-4439 Ph: (636) 386-9224 | Mrs Kristen Doherty, AA-C 615 S. New Ballas Rd., Dept. Of Anesthesiology, St. Louis, MO 63141 Ph: (314) 251-4687 |
Mr. Jesse Graham Gibbons, AA-C Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 3635 Vista, St. Louis, MO 63110 Phone: 314-577-8000 | |
Ms. Nancy M Behnen, A.A. Anesthesiologist Assistant Medicare: Medicare Enrolled Practice Location: 3635 Vista Avenue, Fdt-3, St. Louis, MO 63110 Phone: 314-577-8750 Fax: 314-268-5102 | |
Ms. Thalia Fernandez, C-AA Anesthesiologist Assistant Medicare: Not Enrolled in Medicare Practice Location: 615 S. New Ballas Rd. Dept Of Anesthesia, St. Louis, MO 63141 Phone: 636-386-9224 Fax: 636-386-7679 |