Provider Demographics
NPI:1316977101
Name:THURMAN, CHERYL ANN (CRNA)
Entity type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:ANN
Last Name:THURMAN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2315 DOUGHERTY FERRY RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63122-3383
Mailing Address - Country:US
Mailing Address - Phone:314-966-7570
Mailing Address - Fax:314-966-7788
Practice Address - Street 1:2315 DOUGHERTY FERRY RD
Practice Address - Street 2:SUITE 107
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63122-3383
Practice Address - Country:US
Practice Address - Phone:314-966-7570
Practice Address - Fax:314-966-7788
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO077810367500000X
MO077810034175207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO912683273Medicaid
MO912683273Medicaid