Individual
DR. KELLI LOUISE SASADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9555 76TH ST, SUITE 4105, PLEASANT PRAIRIE, WI 53158-1984
(262) 577-8080
(262) 577-8081
Mailing address
9555 76TH ST, SUITE 4105, PLEASANT PRAIRIE, WI 53158-1984
(262) 577-8080
(262) 577-8081
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
57485
WI
207VG0400X
Gynecology Physician
MD60215747
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0281999
DEPT OF LABOR & INDUSTRIES
WA
05
—
1265698690
—
WI
Enumeration date
08/05/2008
Last updated
08/10/2012
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