Individual
KELLY FENTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
32105 E 155TH ST, PLEASANT HILL, MO 64080-8620
(816) 589-0902
Mailing address
32105 E 155TH ST, PLEASANT HILL, MO 64080-8620
(816) 589-0902
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
099428
MO
Other
Enumeration date
09/17/2014
Last updated
09/17/2014
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