Individual
KELLY ANN CULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
111 E WISCONSIN AVE, SUITE 2000, MILWAUKEE, WI 53202-4815
(414) 290-6720
(414) 290-6755
Mailing address
111 E WISCONSIN AVE, SUITE 2000, MILWAUKEE, WI 53202-4815
(414) 290-6720
(414) 290-6755
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036101865
IL
207P00000X
Emergency Medicine Physician
44859-021
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036101865
—
IL
05
—
43509700
—
WI
01
—
930093591
MEDICARE RAILROAD
IL
Enumeration date
04/27/2006
Last updated
11/15/2022
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