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Individual

MOLLY KELLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BSN, MSN, CPNP

Contact information

Practice address
2880 UNIVERSITY AVE, MADISON, WI 53705-3644
(608) 332-6676
Mailing address
2880 UNIVERSITY AVE, MADISON, WI 53705-3644

Taxonomy

Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
1646-33
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
43917900
WI
Enumeration date
06/04/2007
Last updated
02/17/2021
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