Individual
MS. KELSEY LEA SOUTHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NNP
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
2017038733
MO
363LP0200X
Pediatric Nurse Practitioner
Primary
2017038733
MO
Other
Enumeration date
11/01/2017
Last updated
04/14/2026
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