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1760042923
KELLY RAE VANDERMUSS
DE PERE, WI
NPI
1760042923
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Former Name
KELLY RAE MARBLE
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: WI 4704-23)
Enumeration Date
2019-06-19
Last Update Date
2019-12-05
Business Address
KELLY RAE VANDERMUSS PA-C
1381 BRAYDEN LN
DE PERE, WI 54115-9249
Phone number: 920-664-3734
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Mailing Address
KELLY RAE VANDERMUSS PA-C
2502 S ASHLAND AVE
GREEN BAY, WI 54304-5252
Phone number: 920-496-4700
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