Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KELLI BROCKMAN
Active Sole ProprietorPediatrics · BLOOMSDALE, MO
Registration Details
- NPI Number
- 1477818599
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jul 5, 2012 (13.83845658204 yrs)
- Last Updated
- Apr 11, 2022
- License
-
2015011883 (MO)
- Sole Proprietor
- Yes
Practice Information
- Address
-
255 BODERMANBLOOMSDALE, MO, 636279099Browse MO providers · Browse ZIP 63627
- Phone
- 5734839492
- Primary Specialty
-
Pediatrics
208000000X
Other Pediatrics Providers in BLOOMSDALE, MO
| Name | Credential | NPI |
|---|---|---|
| KRISTINA ASSAF | — | 1982345419 |
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.