Provider Demographics
NPI:1811332588
Name:KELTNER, AMI MARIE (CRNA)
Entity type:Individual
Prefix:
First Name:AMI
Middle Name:MARIE
Last Name:KELTNER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:AMI
Other - Middle Name:MARIE
Other - Last Name:SHERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 410273
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64141-0273
Mailing Address - Country:US
Mailing Address - Phone:913-680-6000
Mailing Address - Fax:
Practice Address - Street 1:1318 E 104TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64131-4504
Practice Address - Country:US
Practice Address - Phone:162-565-2008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-07
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS43-557180-121367500000X
MO2013029019367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered