Individual
MR. TIMOTHY BRENT KELL
Active
Individual
MR. TIMOTHY BRENT KELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
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
Update your record
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