Individual
KELLY BRIGGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1120 SHACKELFORD RD, FLORISSANT, MO 63031-4369
(314) 921-4420
Mailing address
PO BOX 955534, SAINT LOUIS, MO 63195-5534
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2016034344
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2016034344
LICENSE
MO
Enumeration date
09/27/2016
Last updated
11/11/2020
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