Provider Demographics
NPI:1033451836
Name:WESTBROOK, KELSEY E (CRNA)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:E
Last Name:WESTBROOK
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:KELSEY
Other - Middle Name:E
Other - Last Name:SCHMIDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:339 CONSORT DR
Mailing Address - Street 2:
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63011-4439
Mailing Address - Country:US
Mailing Address - Phone:314-775-2816
Mailing Address - Fax:636-386-9224
Practice Address - Street 1:615 S NEW BALLAS RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8221
Practice Address - Country:US
Practice Address - Phone:636-386-9224
Practice Address - Fax:636-386-7679
Is Sole Proprietor?:No
Enumeration Date:2013-03-20
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008006788367500000X
MO2013012085367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered