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Individual

KELSTAN LYNCH ELLIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 234-3000
Mailing address
2401 GILLHAM RD, ATTN PROVIDER ENROLLMENT DEPT, KANSAS CITY, MO 64108-4619
(816) 701-5200

Taxonomy

Speciality
Code
Description
License number
State
2080H0002X
Pediatric Hospice and Palliative Medicine Physician
05-40073
KS
2080H0002X
Pediatric Hospice and Palliative Medicine Physician
Primary
2018015474
MO

Other

Enumeration date
03/26/2014
Last updated
03/09/2026
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