Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ethan J Diestler, CRNA

Individual provider Certified Registered Nurse Anesthetist · NPI 1700732807

Ethan J Diestler, CRNA is a Certified Registered Nurse Anesthetist (CRNA) in Saint Louis, Missouri. Works from 2 locations. Licensed in Missouri.

Licensed in
MO
In the registry since
2026
What do these letters mean?
CRNA — Certified Registered Nurse Anesthetist
An advanced practice nurse who administers anaesthesia.

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Practice location Address checks out

10010 Kennerly Rd
Saint Louis, MO 63128-2106
Phone: (314) 525-1000
Fax: (636) 386-7810
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 12345 W Bend Dr, Saint Louis, MO 63128-2182 — (314) 722-2530

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 2026020569 (MO)

Record details

NPI number1700732807
Entity typeIndividual (Type 1)
GenderMale
Credentials CRNA
Sole proprietorNo
NPI enumeratedMarch 10, 2026
Last updated in NPPESMay 14, 2026
Certification dateMay 14, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2026 (0 years in practice)
Accepts Medicare assignment Not indicated

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