Provider Demographics
NPI:1497198915
Name:PLATI, KEELI (CRNA)
Entity Type:Individual
Prefix:
First Name:KEELI
Middle Name:
Last Name:PLATI
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2485 RIDGECREST DR
Mailing Address - Street 2:
Mailing Address - City:ARNOLD
Mailing Address - State:MO
Mailing Address - Zip Code:63010-2268
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:800 SAINTE GENEVIEVE DR
Practice Address - Street 2:
Practice Address - City:SAINTE GENEVIEVE
Practice Address - State:MO
Practice Address - Zip Code:63670-1434
Practice Address - Country:US
Practice Address - Phone:573-883-2751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-15
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013011244367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered