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
Fax: (218) 835-4222
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306865423 NPPES
Minnesota MEDICAID 180115500

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