Provider Demographics
NPI:1346914249
Name:MUELLER, KELLI RENEE
Entity Type:Individual
Prefix:
First Name:KELLI
Middle Name:RENEE
Last Name:MUELLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KELLI
Other - Middle Name:RENEE
Other - Last Name:BABLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:N3152 STATE ROAD 81
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WI
Mailing Address - Zip Code:53566-8821
Mailing Address - Country:US
Mailing Address - Phone:083-289-3936
Mailing Address - Fax:608-328-9480
Practice Address - Street 1:N3152 STATE ROAD 81
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WI
Practice Address - Zip Code:53566-8821
Practice Address - Country:US
Practice Address - Phone:608-328-9393
Practice Address - Fax:608-328-9480
Is Sole Proprietor?:No
Enumeration Date:2021-08-04
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker