Provider Demographics
NPI:1083003800
Name:WELNA, KELLIANNE ELIZABETH
Entity Type:Individual
Prefix:
First Name:KELLIANNE
Middle Name:ELIZABETH
Last Name:WELNA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 RICHMOND ST
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-3129
Mailing Address - Country:US
Mailing Address - Phone:651-354-5511
Mailing Address - Fax:
Practice Address - Street 1:217 RICHMOND ST
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-3129
Practice Address - Country:US
Practice Address - Phone:651-354-5511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-16
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula