Individual
KELLY R EELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2223 LIME KILN RD, GREEN BAY, WI 54311-6213
(920) 430-8120
(920) 965-7418
Mailing address
2223 LIME KILN RD, GREEN BAY, WI 54311-6213
(920) 430-8120
(920) 965-7418
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1506
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43911000
—
WI
Enumeration date
05/08/2006
Last updated
05/11/2011
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