Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 261-033 | WI |
NPI | 1063617850 |
---|---|
Provider Name | Arlene V Kellett |
First Address | Rhinelander, WI 54501-0400 |
Second Address | Rhinelander, WI 54501-0400 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2007 |
Last Update Date | 08/07/2007 |