Individual
KELSEY KIENERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
101 MAIN ST, NEENAH, WI 54956
(920) 720-1463
Mailing address
101 MAIN ST, NEENAH, WI 54956-2570
(920) 720-1463
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
68772
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100080233
—
WI
Enumeration date
06/25/2015
Last updated
02/21/2024
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