Individual
KELLI HUMMEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1950 DIAMOND PKWY, NORTH KANSAS CITY, MO 64116-4328
(816) 561-3003
Mailing address
8855 N CONGRESS AVE APT 311, KANSAS CITY, MO 64153-1881
(816) 825-1268
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
2021037220
MO
Other
Enumeration date
01/27/2020
Last updated
01/19/2022
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