Individual
MRS. KRISTEN DOHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AA-C
Contact information
Practice address
615 S. NEW BALLAS RD., DEPT. OF ANESTHESIOLOGY, ST. LOUIS, MO 63141
(314) 251-4687
(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
2014016080
MO
Other
Enumeration date
12/23/2013
Last updated
10/15/2015
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