Individual
KELLY C COMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
10701 W RESEARCH DR, WAUWATOSA, WI 53226-3452
(414) 443-4801
(855) 221-4968
Mailing address
10701 W RESEARCH DR, WAUWATOSA, WI 53226-3452
(414) 443-4801
(855) 221-4968
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2186-033
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100033061
—
WI
Enumeration date
01/11/2008
Last updated
12/06/2023
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