Individual
MS. KELLY EILIS LAVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
620 S TAYLOR AVE, DIV IM INFECTIOUS DISEASE, STE 100, SAINT LOUIS, MO 63110-1035
(314) 747-1206
(314) 222-6252
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 747-1206
(314) 222-6252
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2022045232
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
420129228
—
MO
Enumeration date
07/25/2023
Last updated
04/17/2025
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