Individual
KELLIE ANNE MAXWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
316 2ND AVE W, WILLISTON, ND 58801-5218
(701) 774-4600
Mailing address
316 2ND AVE W, WILLISTON, ND 58801-5218
(701) 774-4600
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
247200000X
Other Technician
—
—
Other
Enumeration date
11/01/2024
Last updated
01/08/2026
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