Individual
KELSEY R GERENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
200 E RYAN RD, OAK CREEK, WI 53154-4563
(414) 570-4330
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
14143
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100259788
—
WI
Enumeration date
11/01/2023
Last updated
01/25/2024
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