MR. TIMOTHY J GRAHAM CRNA
NPI 1699747766
Nurse Anesthetist, Certified Registered in Saint Louis, MO

Active since February 03, 2006
12634 OLIVE BLVD, STE 122, SAINT LOUIS, MO 63141(314) 996-8378(314) 996-8910 Get Directions Write a Review

NPPES record last updated: July 17, 2009. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Mr. Timothy J Graham Crna NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. TIMOTHY J GRAHAM CRNA (NPI 1699747766) is an individual nurse anesthetist, certified registered in Saint Louis, Missouri, licensed in Missouri (074653) and active in the NPI registry since February 2006.

NPPES Registry Identity

NPI1699747766
Entity TypeIndividualMale
Primary Taxonomy367500000X
Provider Legal NameMR. TIMOTHY J GRAHAMCredential: CRNA
Location Address12634 OLIVE BLVD, STE 122Saint Louis, MO 63141-6337
Mailing Address660 S Euclid Ave, C B 8054Saint Louis, MO 63110-1010 · (314) 996-8378 · Fax (314) 996-8910
Fax(314) 996-8910
Sole ProprietorNo
Enumeration DateFebruary 3, 2006
Last NPPES UpdateJuly 17, 2009
NPI 1699747766 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
License Licensed in MO · 074653
Definition

(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.

12634 OLIVE BLVD, Saint Louis, MO 63141

Other Identifiers 2

Medicare PIN838640042
Medicaid$$$$$$$$$001IL

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Anesthetist, Certified Registered
12634 OLIVE BLVD
SAINT LOUIS, MO 63141
Nurse Anesthetist, Certified Registered
12634 OLIVE BLVD
SAINT LOUIS, MO 63141
Nurse Anesthetist, Certified Registered
12634 OLIVE BLVD
SAINT LOUIS, MO 63141
Nurse Anesthetist, Certified Registered
12634 OLIVE BLVD
SAINT LOUIS, MO 63141
Emergency Medicine
12634 OLIVE BLVD
SAINT LOUIS, MO 63141
Nurse Anesthetist, Certified Registered
12634 OLIVE BLVD
SAINT LOUIS, MO 63141
Nurse Anesthetist, Certified Registered
12634 OLIVE BLVD
SAINT LOUIS, MO 63141
Internal Medicine
12634 OLIVE BLVD
SAINT LOUIS, MO 63141

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1699747766, enumerated as an "individual" on February 03, 2006.

The provider is located at 12634 OLIVE BLVD STE 122 SAINT LOUIS, MO 63141 and the phone number is (314) 996-8378.

Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.