MEDICARE: AMI MARIE KELTNER CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	43-557180-121	KS
2	367500000X	Certified Registered Nurse Anesthetist	2013029019	MO

General Provider Information

NPI Number	:	1811332588
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMI MARIE KELTNER CRNA

Provider Business Mailing Address
First Line	:	PO BOX 410273
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64141-0273
Country	:	US
Telephone Number	:	913-680-6000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1318 E 104TH ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64131-4504
Country	:	US
Telephone Number	:	162-565-2008
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/07/2013
Last Update Date	:	07/30/2025

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