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Individual

MARCIA S KELLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN CNP

Contact information

Practice address
240 WILLOW ST, TYLER, MN 56178-1166
(507) 247-5921
(507) 247-5184
Mailing address
240 WILLOW ST, TYLER, MN 56178-1166
(507) 247-5921
(507) 247-5184

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
R0790585
MN
363LF0000X
Family Nurse Practitioner
Primary
0790585
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
863387800
MN
Enumeration date
02/23/2006
Last updated
03/08/2021
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