Individual provider · NPI-1

Kelsey Kujellis, PA

Physician Assistant · Oak Creek, WI

NPI number1003382920
StatusActive
Last updated in NPPESDec 17, 2024

Details

NPI
1003382920
Entity type
Individual (NPI-1)
Name
Kelsey Kujellis
Credential
PA
Sex
Female
Sole proprietor
No
Enumeration date
Oct 18, 2018
Certification date
Dec 17, 2024
Last updated
Dec 17, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363A00000X Physician Assistant4516WIYes

Practice location

200 E Ryan Rd
Oak Creek, WI 53154-4563

Phone 414-570-3590 · Fax 414-570-3599

Mailing address

Po Box 735044
Chicago, IL 60673-5044

Phone 800-326-2250

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