Individual
DR. KRYSTAL ANNE KEUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
12000 WORNALL ROAD, KANSAS CITY, MO 64145-1117
(816) 941-1000
(816) 941-1500
Mailing address
9221 WARD PARKWAY, STE. 1000, KANSAS CITY, MO 64114-3337
(816) 363-2600
(816) 523-0068
Taxonomy
Speciality
Code
Description
License number
State
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
Primary
2010013492
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04-34429
STATE LICENSE
KS
01
—
2010013492
STATE LICENSE
MO
Enumeration date
05/14/2007
Last updated
08/23/2010
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