Individual
MS. COLLEEN ELIZABETH KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPAS,PA-C
Contact information
Practice address
5000 W NATIONAL AVE, MILWAUKEE, WI 53295-0001
(414) 384-2000
(414) 389-4134
Mailing address
65 E FIELDSTONE CIR APT 2, OAK CREEK, WI 53154-2185
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
09/02/2006
Last updated
07/08/2007
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