Individual
KELLI KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4000 STATE ROAD 16, LA CROSSE, WI 54601-1809
(608) 784-3886
Mailing address
W4135 CERESA DR, WEST SALEM, WI 54669-9555
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
Primary
169125-30
WI
Other
Enumeration date
03/27/2026
Last updated
03/27/2026
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