Individual
MR. TIMOTHY BRENT KELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
621 S NEW BALLAS RD STE 228A, SAINT LOUIS, MO 63141-8256
(314) 251-4966
Mailing address
621 S NEW BALLAS RD STE 228A, SAINT LOUIS, MO 63141-8256
(314) 251-4966
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
2000151380
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1346415718
—
MO
01
—
P00995895
RAILROAD MEDICARE
MO
Enumeration date
04/28/2008
Last updated
10/26/2023
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