Individual
KELLIE ANN PRENTICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP - BC
Contact information
Practice address
101 WILLMAR AVE SW, WILLMAR, MN 56201-3556
(320) 231-5000
Mailing address
101 WILLMAR AVE SW, WILLMAR, MN 56201-3556
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R132677-0
MN
Other
Enumeration date
10/25/2014
Last updated
03/30/2023
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