Miller, Kelly E
Miller, Kelly E is an individual health care provider with primary practice located at 975 Port Washington Rd , Grafton WI 53024-9201. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Miller, Kelly E can be contacted via phone (262) 329-1000.Contact Information
Primary practice address
975 Port Washington Rd
Grafton WI 53024-9201
Phone: (262) 329-1000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 2012-023 | Wisconsin |
Profile Details
| NPI number | 1770505513 |
|---|---|
| LBN Legal business name | Miller, Kelly E |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 24th, 2006 |
| Last updated | Oct 16th, 2023 - about last year |
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 | 1770505513 | NPPES |
| Wisconsin | MEDICAID | 42890200 |
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