Individual
DR. KELLI K PETTIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1111 DELAFIELD ST,, STE 209, WAUKESHA, WI 53188-3403
(262) 542-0444
(262) 542-8214
Mailing address
1111 DELAFIELD ST,, STE 209, WAUKESHA, WI 53188-3403
(262) 542-0444
(262) 542-8214
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
48072-020
WI
2086S0129X
Vascular Surgery Physician
48072-020
WI
2086X0206X
Surgical Oncology Physician
48072-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477643807
—
WI
Enumeration date
10/14/2006
Last updated
04/24/2019
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