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Individual

MR. ROBERT M KELLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
4061 OLD PESHTIGO RD, MARINETTE, WI 54143
(715) 732-8000
(715) 732-8148
Mailing address
3301 W FOREST HOME AVE, MILWAUKEE, WI 53215-2843
(414) 647-6326
(414) 671-8860

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
1041-033
WI
367500000X
Certified Registered Nurse Anesthetist
Primary
68358-030
WI

Other

Enumeration date
08/23/2006
Last updated
07/08/2007
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