Malloy, Kelly Kathleen
Malloy, Kelly Kathleen is an individual health care provider with primary practice located at 1881 Chicago St , De Pere WI 54115-3770. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Malloy, Kelly Kathleen can be contacted via phone (920) 403-8000.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | 52534 | Wisconsin |
Profile Details
| NPI number | 1578787073 |
|---|---|
| LBN Legal business name | Malloy, Kelly Kathleen |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 13th, 2007 |
| Last updated | Jul 11th, 2024 - about 4 months 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 | 1578787073 | NPPES |
| Wisconsin | MEDICAID | 100016355 |
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