Individual
THERON ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
915 N GRAND BLVD, SAINT LOUIS, MO 63106-1621
(314) 652-4100
Mailing address
915 N GRAND BLVD, SAINT LOUIS, MO 63106-1621
(314) 652-4100
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
2014001228
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
209012165
IL
Other
Enumeration date
01/21/2014
Last updated
09/08/2025
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