Individual
MRS. KELLY M ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
12700 SOUTHFORK RD, SAINT LOUIS, MO 63128-3206
(314) 525-1798
(314) 525-4469
Mailing address
12700 SOUTHFORK RD, SAINT LOUIS, MO 63128-3206
(314) 525-1798
(314) 525-4469
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2016034715
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1568912129
—
MO
Enumeration date
10/07/2016
Last updated
01/16/2025
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