Individual
PRIYA SURESH KANNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12680 OLIVE BLVD STE 300, SAINT LOUIS, MO 63141-6322
(314) 251-8888
Mailing address
12680 OLIVE BLVD STE 300, SAINT LOUIS, MO 63141-6322
(314) 251-8888
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2026015368
MO
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/08/2026
Last updated
04/15/2026
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