Individual
KELLY A PICKENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
301 E 2ND ST, RICHLAND CENTER, WI 53581-1900
(608) 647-6161
(608) 647-3178
Mailing address
2917 INTERNATIONAL LN, PO BOX 14017, MADISON, WI 53704-3135
(608) 245-3354
(866) 903-5812
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2602
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0852480001
DMERC
WI
05
—
41264700
—
WI
Enumeration date
08/03/2005
Last updated
06/26/2012
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