Kelly Baker, PAC
Physician Assistant in Milwaukee, WI. Individual provider (NPI-1).
NPI number1043663818
StatusActive
Last updated in NPPESJan 15, 2021
Details
- NPI
- 1043663818
- Entity type
- Individual (NPI-1)
- Name
- Kelly Baker
- Credential
- PAC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 18, 2016
- Certification date
- Jan 15, 2021
- Last updated
- Jan 15, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 3828 | WI | Yes |
Other names
- Kelly Brock (Former Name)
Practice location
9000 W Wisconsin AveMilwaukee, WI 53226-4874
Phone 414-266-6457 · Fax 414-266-2294
Mailing address
9000 W Wisconsin AveMilwaukee, WI 53226-4874
Phone 414-266-6457 · Fax 414-266-2294
Other practice locations
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