Individual
TONYA L DRAVES-WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
525 COUCH AVE, ST. LOUIS, MO 63122
(314) 966-1500
Mailing address
13523 BARRETT PARKWAY DR, STE 210, BALLWIN, MO 63021-3802
(314) 775-2816
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2003021073
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
916300908
—
MO
Enumeration date
08/07/2007
Last updated
05/02/2008
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