Individual
JEAN E KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN, RN
Contact information
Practice address
1150 GRAHAM RD STE 101, FLORISSANT, MO 63031-8077
(314) 206-3800
(314) 209-3992
Mailing address
1430 OLIVE ST STE 400, SAINT LOUIS, MO 63103-2303
(314) 206-3700
(314) 206-3708
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
2017044682
MO
Other
Enumeration date
12/08/2021
Last updated
12/08/2021
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