KELLY THEODORE

MILWAUKEE, WI
NPI1821472226
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: WI  6467)
Additional Taxonomies363LF0000X Nurse Practitioner, Family
(Licence: WI  6467-33)
Enumeration Date2015-07-15
Last Update Date2022-02-13
Business Address
KELLY THEODORE PMHNP, FNP
930 E KNAPP ST STE 34
MILWAUKEE, WI 53202
Phone number: 414-671-9355
Mailing Address
KELLY THEODORE PMHNP, FNP
345 W RAVINE BAYE RD
BAYSIDE, WI 53217-1336
Phone number: 262-308-7989