Pettit, Kelli K
Pettit, Kelli K is an individual health care provider with primary practice located at 1111 Delafield St, Ste 209, Waukesha WI 53188-3403. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Vascular Surgery, Allopathic & Osteopathic Physicians / Surgical Oncology, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Surgery is her primary health care specialty. Pettit, Kelli K can be contacted via phone (262) 542-0444.Contact Information
Primary practice address
1111 Delafield St, Ste 209
Waukesha WI 53188-3403
Phone: (262) 542-0444
Fax: (262) 542-8214
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Vascular Surgery | 2086S0129X | 48072-020 | Wisconsin |
| Allopathic & Osteopathic Physicians / Surgical Oncology | 2086X0206X | 48072-020 | Wisconsin |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 48072-020 | Wisconsin |
Profile Details
| NPI number | 1477643807 |
|---|---|
| LBN Legal business name | Pettit, Kelli K |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 14th, 2006 |
| Last updated | Apr 24th, 2019 - about 6 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 | 1477643807 | NPPES |
| Wisconsin | MEDICAID | 1477643807 |
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