Individual
KELLY VEVEA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
290 MAIN ST NW, ELK RIVER, MN 55330-1270
(612) 672-2986
Mailing address
2605 YUKON AVE S, SAINT LOUIS PARK, MN 55426-2422
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2016018311
MN
Other
Enumeration date
08/03/2016
Last updated
08/03/2016
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