Individual
MR. GARY G NITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1 BARNES JEWISH HOSPITAL PLZ, SAINT LOUIS, MO 63110-1003
(314) 362-6973
(314) 362-1185
Mailing address
660 S EUCLID AVE, C B 8054, SAINT LOUIS, MO 63110-1010
(314) 362-6973
(314) 362-1185
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
064569
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
054060042
—
MO
05
—
487525631001
—
IL
Enumeration date
07/14/2006
Last updated
10/22/2015
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