Provider Demographics
NPI:1679898910
Name:MURAWSKI, KELLY KATHLEEN (PNP-AC)
Entity Type:Individual
Prefix:MS
First Name:KELLY
Middle Name:KATHLEEN
Last Name:MURAWSKI
Suffix:
Gender:F
Credentials:PNP-AC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1465 SOUTH GRAND BLVD
Mailing Address - Street 2:
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63104
Mailing Address - Country:US
Mailing Address - Phone:314-577-5395
Mailing Address - Fax:314-268-6459
Practice Address - Street 1:1465 S GRAND BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63104-1003
Practice Address - Country:US
Practice Address - Phone:314-577-5395
Practice Address - Fax:314-268-6459
Is Sole Proprietor?:No
Enumeration Date:2010-03-30
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO142153363LP0222X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0222XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics, Critical Care