Breanna Lynn Keller, MSCCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2004021468 Issued in MO

Practice address

850 Country Manor LN
Creve Coeur, MO 63141-6651

Phone

(314) 434-5900

Fax

(314) 434-3927

NPI assigned

Jan 19, 2013

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1358553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358553600000",
    "number": "1164760534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1219 RAINTREE PASS",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633664421",
            "telephone_number": "314-494-2438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 COUNTRY MANOR LN",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631416651",
            "telephone_number": "314-434-5900",
            "fax_number": "314-434-3927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "BREANNA",
        "middle_name": "LYNN",
        "credential": "MSCCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-19",
        "last_updated": "2013-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2004021468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Kauffman
• KDB Enterprises, Inc
• Karla Keaney, M.D.
• Abbe Michelle Keen, D.C.
• Dennis J Keithly, MD
• Allison Kelley, OTR/L
• Robert Francis Kelly, PA-C
• Nancy Ketring Kennedy, O.D.
• Saad Z Khan, M.D.
• Sunna Khan, MD

• Speech-Language Pathologist in Creve Coeur, MO
• Providers in Creve Coeur, MO by specialty
• Speech-Language Pathologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.