Individual
KELLI TORNSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
800 WEST AVE S, LA CROSSE, WI 54601-8806
(608) 785-0940
Mailing address
PO BOX 1510, EAU CLAIRE, WI 54702-1510
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
5002
MN
363L00000X
Nurse Practitioner
Primary
6432
WI
363LA2100X
Acute Care Nurse Practitioner
6432-33
WI
Other
Enumeration date
06/25/2015
Last updated
09/15/2020
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