Individual
ANNE M KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
516 DELAWARE STREET, PWB FOURTH FLOOR, ROOM 4-100, MINNEAPOLIS, MN 55455
(612) 672-7122
Mailing address
420 DELAWARE ST SE MMC 391, UNIVERSITY OF MINNESOTA PHYSICIANS, MINNEAPOLIS, MN 55455
(612) 672-7122
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
33787
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
053876
FAIRVIEW
MN
05
—
0908632
—
IA
01
—
1000079
PREFERRED ONE
MN
01
—
100911
UCARE
MN
01
—
1224912
MEDICA-CHOICE
MN
01
—
1274813
MEDICA-PRIMARY
MN
01
—
768191
ARAZ
—
01
—
7T749KE
BCBS
MN
01
—
HP21986
HEALTH PARTNERS
MN
Enumeration date
10/11/2006
Last updated
07/09/2007
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