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General NPI Number Information
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NPI Number | 1336276096
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Entity Type | Individual
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Provider Name | KELLY A. PATEL NP
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Gender | Female
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 08/15/2012
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Provider Practice Location Address
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Address Line | 1035 BELLEVUE AVE SUITE 305
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City | SAINT LOUIS
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State | MO
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Zip | 63117-1854
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Country | US
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Telephone | 314-925-4700
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Fax | 314-925-4716
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Provider Business Mailing Address
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Address Line | 10777 SUNSET OFFICE DR
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City | SAINT LOUIS
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State | MO
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Zip | 63127-1019
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Country | US
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Telephone | 314-822-5900
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 2004007219
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License Number State | MO
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