Zalog, Kelly A

Zalog, Kelly A is an individual health care provider with primary practice located at 19035 W Capitol Dr Suite 101, Brookfield WI 53045-2706. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Zalog, Kelly A can be contacted via phone (262) 754-1421.

Contact Information

Primary practice address
19035 W Capitol Dr Suite 101 Brookfield WI 53045-2706
Fax: (262) 754-3760
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 715-023 Wisconsin

Profile Details

NPI number 1952381790
LBN Legal business name Zalog, Kelly A
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 18th, 2006
Last updated Jul 8th, 2007 - about 19 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 1952381790 NPPES
Wisconsin MEDICAID 42942500

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