Provider Demographics
NPI:1457540171
Name:FELMER, KELLY ANN (GNP, APNP)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:ANN
Last Name:FELMER
Suffix:
Gender:F
Credentials:GNP, APNP
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:ANN
Other - Last Name:GALLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1601 S. WEBSTER AVENUE
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54301
Mailing Address - Country:US
Mailing Address - Phone:920-343-6443
Mailing Address - Fax:920-542-6223
Practice Address - Street 1:1601 S. WEBSTER AVENUE
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54301
Practice Address - Country:US
Practice Address - Phone:920-343-6443
Practice Address - Fax:920-542-6223
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-18
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1495-033363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology