Individual
KELLY C GRECO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
3800 PARK NICOLLET BLVD, DEPARTMENT OF DERMATOLOGY, ST LOUIS PARK, MN 55416-2527
(952) 993-3260
(952) 993-0333
Mailing address
500 OSBORNE RD NE DEPT OF, FRIDLEY, MN 55432-2765
(763) 786-6011
(763) 684-2505
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11710
MN
363A00000X
Physician Assistant
—
WI
Other
Enumeration date
06/25/2013
Last updated
03/15/2021
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