Individual
SUZANNE KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
218 MAIN ST, COLD SPRING, MN 56320-2533
(320) 685-3020
Mailing address
218 MAIN ST, COLD SPRING, MN 56320-2533
(320) 685-3020
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R 147009-5
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R 147009-5
NURSING LICENSE
MN
Enumeration date
06/09/2014
Last updated
06/16/2014
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