Individual
KYLE T GRIFFITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10010 KENNERLY RD, SAINT LOUIS, MO 63128-2106
(636) 386-7222
(636) 386-7810
Mailing address
7416 CREEK RIDGE LN, EDWARDSVILLE, IL 62025-7047
(314) 504-5140
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2001015666
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
075254
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
910186709
—
MO
Enumeration date
01/20/2006
Last updated
10/07/2015
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