Individual
TAYLOR KELLAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
835 S VAN BUREN ST, GREEN BAY, WI 54301-3526
(920) 433-0111
Mailing address
835 S VAN BUREN ST, GREEN BAY, WI 54301-3526
(920) 433-0111
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
8441-23
WI
363A00000X
Physician Assistant
Primary
8441-23
WI
Other
Enumeration date
06/20/2023
Last updated
02/10/2026
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