Individual
KELLIE GREENWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3003 W GOOD HOPE RD, MILWAUKEE, WI 53209-2042
(414) 352-3100
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
229334-30
WI
363L00000X
Nurse Practitioner
Primary
10270
WI
363LF0000X
Family Nurse Practitioner
10270-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100104190
—
WI
Enumeration date
02/28/2020
Last updated
08/29/2023
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