Individual
MRS. KELLY MUKTI FLYNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
430 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 929-2300
Mailing address
3301 W FOREST HOME AVE, MILWAUKEE, WI 53215-2843
(920) 303-8700
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
7895
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100073374
—
WI
Enumeration date
07/24/2011
Last updated
05/15/2025
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