Individual
KELLY A GORDON-MEYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
9200 W WISCONSIN AVE, DEPARTMENT OF EMERGENCY MEDICINE, MILWAUKEE, WI 53226-3522
(414) 805-6450
(414) 805-6464
Mailing address
9200 W WISCONSIN AVE, DEPARTMENT OF EMERGENCY MEDICINE, MILWAUKEE, WI 53226-3522
(414) 805-6450
(414) 805-6464
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
126585
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1275849630
—
WI
Enumeration date
08/24/2010
Last updated
11/01/2012
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