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Individual

KATRECE LEVOY ELLIS

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) 996-5161
Mailing address
3015 N BALLAS RD, SAINT LOUIS, MO 63131-2329
(314) 996-5161

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2023038162
MO
367500000X
Certified Registered Nurse Anesthetist
792959
TX
367500000X
Certified Registered Nurse Anesthetist
RN142620
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1265723530
GA
05
2301306
LA
05
281584701
TX
05
281584702
TX
Enumeration date
04/21/2011
Last updated
04/16/2024
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