Provider Demographics
NPI:1811332588
Name:KELTNER, AMI MARIE (CRNA)
Entity type:Individual
Prefix:MRS
First Name:AMI
Middle Name:MARIE
Last Name:KELTNER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:AMI
Other - Middle Name:MARIE
Other - Last Name:SHERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2604 WHITMORE DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66046-5300
Mailing Address - Country:US
Mailing Address - Phone:816-225-9318
Mailing Address - Fax:
Practice Address - Street 1:7111 FAIRWAY DR
Practice Address - Street 2:SUITE 450
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33418-4204
Practice Address - Country:US
Practice Address - Phone:561-623-2054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-07
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007019207367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered