Individual
KELLY USITALO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
913 E 26TH STREET, PIPER BUILDING SUITE 401, MINNEAPOLIS, MN 55407
(612) 863-7501
Mailing address
653 19TH AVE NE, MINNEAPOLIS, MN 55418-4441
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
6080
MN
Other
Enumeration date
08/17/2018
Last updated
03/11/2021
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