Healthcare Provider Details

I. General information

NPI: 1205588209
Provider Name (Legal Business Name): KELSEY SCHIEBER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2022
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2799 N WASHINGTON ST
CHILLICOTHEE MO
64601-2902
US

IV. Provider business mailing address

510 SE 5TH AVE APT 605
FORT LAUDERDALE FL
33301-2994
US

V. Phone/Fax

Practice location:
  • Phone: 660-646-1480
  • Fax:
Mailing address:
  • Phone: 660-663-7900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number11017315
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN11017315
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number2025010437
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: