Individual
CARISSA JO KELM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
312 9TH ST. SW, WAVERLY, IA 50677
(319) 352-4120
Mailing address
312 9TH STREET SW, WAVERLY, IA 50677
(319) 352-4120
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
H174874
IA
Other
Enumeration date
06/26/2023
Last updated
06/26/2023
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