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General NPI Number Information
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NPI Number | 1851953020
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Entity Type | Individual
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Provider Name | KELLEY MARIE KIEL BSN,RN,RNFA,CNOR
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Gender | Female
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Dates
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Enumeration Date | 07/08/2019
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Last Update Date | 07/08/2019
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Provider Practice Location Address
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Address Line | 621 S NEW BALLAS RD STE 537A
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City | SAINT LOUIS
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State | MO
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Zip | 63141-8261
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Country | US
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Telephone | 314-251-6990
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Fax | 314-251-6998
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Provider Business Mailing Address
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Address Line | 1417 SUMMERGATE PKWY
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City | SAINT PETERS
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State | MO
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Zip | 63303-6383
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Country | US
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Telephone | 618-520-2106
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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 | 163WR0006X
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Taxonomy Name | Registered Nurse First Assistant
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License Number | 2010008866
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License Number State | MO
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