MRS. KELLY MARIE PANTAZO NP-C NPI 1306326855

NPI Information

  • NPI: 1306326855
  • Provider Name: MRS. KELLY MARIE PANTAZO, NP-C
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 3647 KNEFF FARM XING
    IMPERIAL, MO
    ZIP 63052
  • Phone: (314) 882-1978

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NPI Details

MRS. Kelly Marie Pantazo, NP-C is a family nurse practitioner in Imperial, MO with 7 years of experience. MRS. Kelly Marie Pantazo, NP-C NPI is 1306326855. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3647 KNEFF FARM XING
IMPERIAL, MO
ZIP 63052-887
Phone: (314) 882-1978

The NPI 1306326855 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/15/2018 and was last updated on 8/15/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamily2018024080MISSOURIYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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