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Individual

DR. ELIAS KIPTOO MELLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1600 E BROADWAY, COLUMBIA, MO 65201-5844
(573) 815-8000
Mailing address
4005 TREETOP LN, COLUMBIA, MO 65202-6216

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2019034633
MO
367500000X
Certified Registered Nurse Anesthetist
D164053
IA

Other

Enumeration date
09/05/2019
Last updated
05/05/2025
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