Individual
MARY R KELM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
420 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-8230
Mailing address
420 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-8340
(920) 926-8370
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
16033
WI
Other
Enumeration date
09/22/2005
Last updated
03/28/2016
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