Individual
MS. LISA ANN DURAKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1465 S GRAND BLVD, DEPT OF ANESTHESIOLOGY, SAINT LOUIS, MO 63104-1003
(314) 577-8750
Mailing address
3635 VISTA AVE, FDT-3, SAINT LOUIS, MO 63110-2539
(314) 577-8750
(314) 268-5102
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
88270
MO
Other
Enumeration date
01/30/2012
Last updated
04/29/2012
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