Individual
KELSEY JO KOYANAGI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3015 N BALLAS RD, SAINT LOUIS, MO 63131-2329
(314) 996-5000
Mailing address
3015 N BALLAS RD, SAINT LOUIS, MO 63131-2329
(314) 996-5000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041425149
IL
163W00000X
Registered Nurse
2016040159
MO
367500000X
Certified Registered Nurse Anesthetist
10043837
OR
367500000X
Certified Registered Nurse Anesthetist
Primary
2022025022
MO
Other
Enumeration date
04/13/2022
Last updated
09/08/2025
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