Most Relevant Information
Provider Data
| NPI Number: | 1003272642 |
| Provider Name: | MARY KATHERINE KINWORTHY CRNA |
| Entity Type: | Individual |
| Taxonomy Code: | 367500000X |
| Specialty: | Nurse Anesthetist, Certified Registered |
| License Number: | 2018003033 |
Most Important Dates
| Enumeration Date: | 01/12/2016 |
| Last Updated: | 04/25/2024 |
Provider Practice Location
12634 OLIVE BLVD
DEPT ANESTHESIOLOGY
SAINT LOUIS
MO
631416337
Practice Location Phone/Fax
| Phone: | 8008629980 |
| Fax: | 3143621185 |
Provider Mailing Location
PO BOX 60352
SAINT LOUIS
MO
631600352
Provider Mailing Phone/Fax
| Phone: | 8008629980 |
| Fax: | 3143621185 |