Quandt, Kelly Marie
Quandt, Kelly Marie is an individual health care provider with primary practice located at 11270 N Port Washington Rd , Mequon WI 53092-3410. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Quandt, Kelly Marie can be contacted via phone (262) 241-1022.Contact Information
Primary practice address
11270 N Port Washington Rd
Mequon WI 53092-3410
Phone: (262) 241-1022
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 4290-33 | Wisconsin |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 4290-33 | Wisconsin |
Profile Details
| NPI number | 1538462650 |
|---|---|
| LBN Legal business name | Quandt, Kelly Marie |
| Credentials | NURSE PRACTITIONER |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 11th, 2010 |
| Last updated | Apr 15th, 2024 - about 7 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 | 1538462650 | NPPES |
| Wisconsin | MEDICAID | 100014882 |
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