Individual
MS. KELLY COTALEEN TODD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
25340 1300 EAST ST, WALNUT, IL 61376-9274
(815) 310-6222
Mailing address
2646 PARK AVE, SAINT LOUIS, MO 63104-2024
(815) 310-6222
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
2018004205
MO
363LP0200X
Pediatric Nurse Practitioner
Primary
277001500
IL
363LP0200X
Pediatric Nurse Practitioner
MCS006520B
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
420071827
—
MO
Enumeration date
04/18/2018
Last updated
08/02/2022
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us