Individual
MRS. ALICIA S KELCH
Active
Individual
MRS. ALICIA S KELCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2367-23
WI
363AM0700X
Medical Physician Assistant
Primary
2367-023
WI
363AM0700X
Medical Physician Assistant
236723
WI
363AM0700X
Medical Physician Assistant
MA052264
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1942452289
BLUE SHIELD
WI
05
—
1942452289
—
WI
Enumeration date
10/17/2008
Last updated
04/01/2019
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