Provider Demographics
NPI:1265064703
Name:GREUBEL, KELSEY ELIZABETH (ACNP)
Entity type:Individual
Prefix:MS
First Name:KELSEY
Middle Name:ELIZABETH
Last Name:GREUBEL
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:KELSEY
Other - Middle Name:
Other - Last Name:ORTMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:660 S EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1010
Mailing Address - Country:US
Mailing Address - Phone:314-362-1700
Mailing Address - Fax:314-362-9878
Practice Address - Street 1:1 BARNES JEWISH HOSPITAL PLZ
Practice Address - Street 2:DIV SURG VASCULAR
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1003
Practice Address - Country:US
Practice Address - Phone:314-273-7373
Practice Address - Fax:888-840-6225
Is Sole Proprietor?:No
Enumeration Date:2020-02-11
Last Update Date:2025-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020006143363L00000X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO420081774Medicaid