Kellan Brett Klubben, MD
Family Medicine in Hayward, WI. Individual provider (NPI-1).
NPI number1144800905
StatusActive
Last updated in NPPESSep 11, 2024
Details
- NPI
- 1144800905
- Entity type
- Individual (NPI-1)
- Name
- Kellan Brett Klubben
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 14, 2021
- Certification date
- Jun 30, 2021
- Last updated
- Sep 11, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 84153-20 | WI | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
11040 N State Rd 77Hayward, WI 54843
Phone 715-934-4910
Mailing address
11040 N State Rd 77Hayward, WI 54843
Phone 715-934-4910
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