Individual
MARISSA RENEE KEHRWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN-C, FNP-C
Contact information
Practice address
1345 N JESSE JAMES RD, EXCELSIOR SPRINGS, MO 64024-1120
(816) 630-9411
(855) 642-2047
Mailing address
1345 N JESSE JAMES RD, EXCELSIOR SPRINGS, MO 64024-1120
(816) 630-9411
(855) 642-2047
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2020003620
MO
363LF0000X
Family Nurse Practitioner
Primary
2020003620
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1487285946
—
MO
Enumeration date
02/03/2020
Last updated
04/08/2021
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