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Individual
JEANNE M KELLEY
Active
Individual
JEANNE M KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
82731-030
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35061900
—
WI
Enumeration date
10/29/2008
Last updated
10/29/2008
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