Individual
KELLY ELIZABETH BUCHANAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3365 S 103RD ST STE 210, MILWAUKEE, WI 53227-4161
(414) 228-4800
(262) 432-9004
Mailing address
3939 W RIDGE RD STE A100, ERIE, PA 16506-1880
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
1530-230
WI
2084P0800X
Psychiatry Physician
38387
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477917532
—
WI
Enumeration date
04/05/2016
Last updated
10/29/2021
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