Individual
MS. SARA RANAE KELLAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP
Contact information
Practice address
1044 N MASON RD, DEPT ORTHOPAEDIC SURGERY, STE 110/210, SAINT LOUIS, MO 63141-6431
(314) 514-3500
(314) 878-7678
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 514-3500
(314) 878-7678
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2019037649
MO
363LA2200X
Adult Health Nurse Practitioner
2019037649
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
420077904
—
MO
Enumeration date
09/21/2019
Last updated
04/17/2025
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