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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MRS. KELLEY JOHANNA BASS, PA-C

Active

MRS. KELLEY JOHANNA BASS, PA-C is a Surgical Physician Assistant healthcare provider located in ST. LOUIS, Missouri. NPI 1316112295 is currently active in the NPPES registry. Verify at CMS.

Surgical Physician Assistant · ST. LOUIS, MO

Registration Details

NPI Number
1316112295
Provider Type
Individual
Gender
Female
NPI Issued
Apr 23, 2008 (18.325693910627 yrs)
Last Updated
Jun 12, 2008
License
2008013830 (MO)

Practice Information

Address
621 S. NEW BALLAS RD.
SUITE 297-A
ST. LOUIS, MO, 631418200
Browse MO providers · Browse ZIP 63141
Phone
3142516364
Fax
3142517897
Primary Specialty
Surgical Physician Assistant
363AS0400X

Other Surgical Physician Assistant Providers in ST. LOUIS, MO

Name Credential NPI
MRS. ALLISON GRACE TUTTLE PA-C 1053359281
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.