Individual
KELLY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
8202 EXCELSIOR DR, MADISON, WI 53717-1906
(608) 831-1766
Mailing address
1265 JOHN Q HAMMONS DR, MADISON, WI 53717-1941
(608) 251-4156
(608) 257-3842
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
117977
WI
Other
Enumeration date
07/19/2006
Last updated
07/08/2007
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