Greenleaf, Kelly Jo

Greenleaf, Kelly Jo is an individual health care provider with primary practice located at 400 E 3Rd St , Duluth MN 55805-1951. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Greenleaf, Kelly Jo can be contacted via phone (218) 786-3800.

Contact Information

Primary practice address
400 E 3Rd St Duluth MN 55805-1951
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 49526 Minnesota

Profile Details

NPI number 1174718316
LBN Legal business name Greenleaf, Kelly Jo
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 11th, 2007
Last updated May 9th, 2011 - about 13 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 1174718316 NPPES
Minnesota MEDICAID 090903300

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