Individual
KELLY E PEZZELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2810 NICOLLET AVE, MINNEAPOLIS, MN 55408-4708
(612) 873-6963
Mailing address
701 PARK AVE, MINNEAPOLIS, MN 55415-1623
(612) 873-3000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R-174313-3
MN
363LF0000X
Family Nurse Practitioner
Primary
2338
MN
363LF0000X
Family Nurse Practitioner
R-174313-3
MN
Other
Enumeration date
01/31/2011
Last updated
03/28/2024
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