Provider Demographics
NPI:1245365592
Name:STEELE, CHARLES DENNIS (CRNA)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:DENNIS
Last Name:STEELE
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 WEST 18TH STREET
Mailing Address - Street 2:
Mailing Address - City:HERMANN
Mailing Address - State:MO
Mailing Address - Zip Code:65041
Mailing Address - Country:US
Mailing Address - Phone:573-486-2191
Mailing Address - Fax:573-486-3743
Practice Address - Street 1:509 WEST 18TH STREET
Practice Address - Street 2:
Practice Address - City:HERMANN
Practice Address - State:MO
Practice Address - Zip Code:65041
Practice Address - Country:US
Practice Address - Phone:573-486-2191
Practice Address - Fax:573-486-3743
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO056362367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered