Kelly, Elaine D
Kelly, Elaine D is an individual health care provider with primary practice located at 1St Ave W & Margaret St , Blackduck MN 56630. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Kelly, Elaine D can be contacted via phone (218) 835-5837.Contact Information
Primary practice address
1St Ave W & Margaret St
Blackduck MN 56630
Phone: (218) 835-5837
Fax: (218) 835-4222
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 9428 | Minnesota |
Profile Details
NPI number | 1306865423 |
---|---|
LBN Legal business name | Kelly, Elaine D |
Credentials | Physician's Assistant Certified (PA-C) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jul 19th, 2006 |
Last updated | Sep 12th, 2008 - 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1306865423 | NPPES |
Minnesota | MEDICAID | 180115500 |
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