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Individual

DIANE M RICHTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
3015 N BALLAS RD, SAINT LOUIS, MO 63131-2329
(314) 996-5000
Mailing address
1836 LACKLAND HILL PKWY, ATTN: CREDENTIALING, SAINT LOUIS, MO 63146-3572
(314) 989-0300

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
066490
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
430021329
RAILROAD MEDICARE
MO
05
912771318
MO
Enumeration date
05/08/2006
Last updated
06/06/2024
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