| Kelli Elizabeth Buntaine, FNP-C | |
|
2991 Highway K, O Fallon, MO 63368-7862 | |
| (636) 435-2333 | |
| (314) 626-8009 |
| Full Name | Kelli Elizabeth Buntaine |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 2991 Highway K, O Fallon, Missouri |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073279568 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163WE0003X | Registered Nurse - Emergency | 149260 (Missouri) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 2022015784 (Missouri) | Primary |
| Entity Name | Mercy East Ambulatory Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134673148 PECOS PAC ID: 2365739240 Enrollment ID: O20160920002054 |
| Mailing Address | Practice Location Address |
|---|---|
| Kelli Elizabeth Buntaine, FNP-C 2991 Highway K, O Fallon, MO 63368-7862 Ph: (636) 435-2333 | Kelli Elizabeth Buntaine, FNP-C 2991 Highway K, O Fallon, MO 63368-7862 Ph: (636) 435-2333 |
Mrs. Shannon M Wood, FNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 9209 Phoenix Village Pkwy, O Fallon, MO 63368 Phone: 636-561-4613 Fax: 636-561-4610 | |
Leah W Wangui, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 225 Mystic Cv, O Fallon, MO 63368 Phone: 314-583-4665 | |
Mrs. Dawn Marie Johns, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 920 N Main St, O Fallon, MO 63366 Phone: 314-687-2731 | |
Brooke Lauren Meyer, RN, MSN, CPNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 300 Winding Woods Dr Ste 101, O Fallon, MO 63366 Phone: 636-978-7902 | |
Mrs. Christina Marie Ivy, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2765 Red Cedar Parc Dr S, O Fallon, MO 63368 Phone: 636-248-8072 | |
Elizabeth Vollmar, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1101 Highway K, O Fallon, MO 63366 Phone: 636-379-6363 | |
Gloria Michelle Paul Edacheril, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 20 Progress Point Pkwy Ste 108, O Fallon, MO 63368 Phone: 636-344-2400 Fax: 636-344-2401 |