Individual
KELLEY MCCARTHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5332 MANSFIELD DR, GREENDALE, WI 53129-1221
(920) 858-6453
Mailing address
5332 MANSFIELD DR, GREENDALE, WI 53129-1221
(920) 858-6453
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
236126-30
WI
367500000X
Certified Registered Nurse Anesthetist
Primary
232136
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100244228
—
WI
Enumeration date
08/26/2021
Last updated
08/18/2025
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