Green, Kelli

Green, Kelli is an individual health care provider with primary practice located at 1801 Hickman Rd Broadlawns Medical Center, Des Moines IA 50314-1505. She recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as her primary health care specialty. Green, Kelli can be contacted via phone (515) 282-2319.

Contact Information

Primary practice address
1801 Hickman Rd Broadlawns Medical Center Des Moines IA 50314-1505
Phone: (515) 282-2319
Fax: (515) 282-3234
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 34796 Iowa

Profile Details

NPI number 1033104294
LBN Legal business name Green, Kelli
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 14th, 2005
Last updated Jul 8th, 2007 - about 17 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 1033104294 NPPES
Iowa MEDICAID 286476

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