Individual
MRS. KELLY RATZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN-FNP
Contact information
Practice address
1738 GILSINN LN, FENTON, MO 63026-2004
(636) 594-7883
(636) 686-6979
Mailing address
6 EARLIGLOW CT, ARNOLD, MO 63010-2577
(314) 560-0439
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
2014023978
MO
363LF0000X
Family Nurse Practitioner
209012039
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2019005550
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209012039
ILLINOIS LICENSE
IL
Enumeration date
09/09/2014
Last updated
06/11/2024
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