Provider Demographics
NPI:1821713926
Name:NORVILLE, ABIGAIL RENEE (CRNA)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:RENEE
Last Name:NORVILLE
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:P O BOX 7412011 DEPT OF ANESTHESIOLOGY
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-2011
Mailing Address - Country:US
Mailing Address - Phone:314-273-6249
Mailing Address - Fax:314-273-0455
Practice Address - Street 1:12634 OLIVE BLVD DEPT OF
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-6337
Practice Address - Country:US
Practice Address - Phone:800-862-9980
Practice Address - Fax:314-362-1185
Is Sole Proprietor?:No
Enumeration Date:2022-10-11
Last Update Date:2025-08-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2020001551163WC0200X
MO2025033739367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine