Individual
KELLI DEUTMEYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
408 PARKWOOD LN, APT 4, MADISON, WI 53714-3549
(563) 581-6830
Mailing address
408 PARKWOOD LN, APT 4, MADISON, WI 53714-3549
(563) 581-6830
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
P56951
IA
Other
Enumeration date
11/08/2013
Last updated
11/08/2013
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