Individual
KELLY LEDOUX GODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3925 N GATEWAY DR, APPLETON, WI 54913-7863
(920) 380-4999
(920) 380-4961
Mailing address
3 NEENAH CTR, NEENAH, WI 54956-3070
(920) 830-5900
(920) 830-5910
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-07941
NC
363A00000X
Physician Assistant
Primary
8503
WI
Other
Enumeration date
03/07/2018
Last updated
10/03/2025
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