Individual
MRS. KELLY JADE PERRO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, APRN, PMHNP-BC
Contact information
Practice address
800 E 28TH ST, MINNEAPOLIS, MN 55407-3723
(612) 863-4000
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-9000
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
9636
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/12/2022
Last updated
01/17/2023
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