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Individual

NICHOLAS S KELLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
1250 N PORT WASHINGTON RD, GRAFTON, WI 53024-9315
(262) 375-6738
Mailing address
1632 N FRANKLIN PL APT 512, MILWAUKEE, WI 53202-3774
(850) 449-9485

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
051302475
IL
183500000X
Pharmacist
Primary
2018040
WI

Other

Enumeration date
12/31/2019
Last updated
03/25/2020
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