Kristbaum, Kelly A

Kristbaum, Kelly A is an individual health care provider with primary practice located at 2901 W Kinnickinnic River Pkwy , Milwaukee WI 53215-3677. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Acute Care, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Kristbaum, Kelly A can be contacted via phone (414) 649-3750.

Contact Information

Primary practice address
2901 W Kinnickinnic River Pkwy Milwaukee WI 53215-3677
Phone: (414) 649-3750
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 154594 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 5165 Wisconsin

Profile Details

NPI number 1215271994
LBN Legal business name Kristbaum, Kelly A
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 19th, 2012
Last updated Nov 20th, 2024 - about 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215271994 NPPES
Wisconsin MEDICAID 1215271994
Wisconsin MEDICAID 100026864

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