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
Phone: (262) 754-1421
Fax: (262) 754-3760
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1952381790 | NPPES |
| Wisconsin | MEDICAID | 42942500 |
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