Individual
KRISTY D KENNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, RN, CPNP
Contact information
Practice address
615 S NEW BALLAS RD, SAINT LOUIS, MO 63141-8221
(314) 251-6299
(314) 251-4450
Mailing address
621 S NEW BALLAS RD, SUITE 6006B, SAINT LOUIS, MO 63141-8232
(314) 251-6299
(314) 251-4450
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
153988
MO
363LP0200X
Pediatric Nurse Practitioner
Primary
2015016097
MO
Other
Enumeration date
05/09/2016
Last updated
05/09/2016
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