Individual
MS. KELLY J PEDAHEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6120 MENCHALVILLE RD, CATO, WI 54230-8223
(920) 559-0172
Mailing address
6120 MENCHALVILLE RD, CATO, WI 54230-8223
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38341500
—
WI
Enumeration date
03/05/2007
Last updated
07/09/2007
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