Individual
MS. KELLY ELIZABETH BALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, NP
Contact information
Practice address
3635 VISTA AVE, SAINT LOUIS, MO 63110-2539
(314) 577-8773
Mailing address
3635 VISTA AVE, SAINT LOUIS, MO 63110-2539
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2013015889
MO
363LA2100X
Acute Care Nurse Practitioner
Primary
2016034314
MO
Other
Enumeration date
07/25/2016
Last updated
09/28/2016
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