Individual
MS. KELLY MARIE HOUSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
3009 N BALLAS RD STE 260C, SAINT LOUIS, MO 63131-2382
(314) 996-7940
(314) 996-7945
Mailing address
PO BOX 959354, SAINT LOUIS, MO 63195-9354
(314) 996-7940
(314) 996-7945
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2016023925
MO
363LA2100X
Acute Care Nurse Practitioner
2016023925
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
420077368
—
MO
Enumeration date
07/06/2016
Last updated
06/04/2026
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