Individual
KELLI FORSYTH MILLICAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
22 S GREENE ST, BALTIMORE, MD 21201-1544
(410) 448-6400
Mailing address
PO BOX 64881, BALTIMORE, MD 21264-4881
(410) 448-6400
(410) 448-6296
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085006375
IL
363AM0700X
Medical Physician Assistant
085006375
—
363AS0400X
Surgical Physician Assistant
085006375
IL
363AS0400X
Surgical Physician Assistant
Primary
C0009685
MD
Other
Enumeration date
10/04/2017
Last updated
10/15/2025
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