OrganizationActive
Lifewave Technology Group LLC
NPI 1861753543 · Certified Registered Nurse Anesthetist · Saint Louis, MO
Provider details
- NPI number
- 1861753543
- Entity type
- Organization
- Primary specialty
- Certified Registered Nurse AnesthetistPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Alysen Baer, Manager(314) 880-0717
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Detailed profile(84/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
14 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
8637 Delmar Blvd
Saint Louis, MO 63124-1906
Phone: (314) 880-0717
Street-level locationGet directions
Mailing address
8637 Delmar Blvd
Saint Louis, MO 63124-1906
Additional practice locations (1)
- 17205 Chesterfield Airport RdChesterfield, MO 63005-1423Phone: (314) 983-0303
Registry dates
- Enumerated
- 2012-05-30
- Last updated
- 2018-09-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.