Individual provider · Type 1 NPI

Kelly Renee Mebruer

Surgical Physician Assistant · St. Louis, MO

NPI number 1144189788 Active

Practice location

1465 S Grand Blvd
St. Louis, MO 63104-1003

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400XNone listed
Physician Assistant 363A00000X2026005849 (MO)

Surgical Physician Assistant: Definition to come...

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About NPI 1144189788

Kelly Renee Mebruer's National Provider Identifier is 1144189788, issued on Jan 20, 2026. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in St. Louis, MO. The record was last updated on Mar 10, 2026.