Individual
MR. NICHOLAS ALEXANDER KUTRUBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C-AA
Contact information
Practice address
615 S NEW BALLAS RD, SAINT LOUIS, MO 63141-8221
(636) 386-9224
(636) 386-7679
Mailing address
339 CONSORT DR, BALLWIN, MO 63011-4439
(636) 386-9224
(636) 386-7679
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
2023003008
MO
367H00000X
Anesthesiologist Assistant
PENDING
MO
Other
Enumeration date
12/14/2022
Last updated
11/18/2024
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