Anderson, Kelle O

Anderson, Kelle O is an individual health care provider with primary practice located at 1687 E Division St , River Falls WI 54022-1571. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Anderson, Kelle O can be contacted via phone (715) 425-6701.

Contact Information

Primary practice address
1687 E Division St River Falls WI 54022-1571
Phone: (715) 425-6701
Fax: (715) 425-7075
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 44896 Minnesota
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 45023020 Wisconsin

Profile Details

NPI number 1093708505
LBN Legal business name Anderson, Kelle O
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2005
Last updated Sep 12th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093708505 NPPES
Wisconsin MEDICAID 34288200

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