Provider Demographics
NPI:1093874950
Name:GRAMITH, ELIZABETH A (CRNA)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:GRAMITH
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6682 EAST HIGHWAY 86
Mailing Address - Street 2:
Mailing Address - City:NEOSHO
Mailing Address - State:MO
Mailing Address - Zip Code:64850
Mailing Address - Country:US
Mailing Address - Phone:417-437-5652
Mailing Address - Fax:
Practice Address - Street 1:509 W 18TH ST
Practice Address - Street 2:
Practice Address - City:HERMANN
Practice Address - State:MO
Practice Address - Zip Code:65041-1547
Practice Address - Country:US
Practice Address - Phone:573-486-2191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-07
Last Update Date:2009-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO061309367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered