Provider Demographics
NPI:1063617850
Name:KELLETT, ARLENE V (WHNP)
Entity type:Individual
Prefix:
First Name:ARLENE
Middle Name:V
Last Name:KELLETT
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 400
Mailing Address - Street 2:OCHD
Mailing Address - City:RHINELANDER
Mailing Address - State:WI
Mailing Address - Zip Code:54501-0400
Mailing Address - Country:US
Mailing Address - Phone:715-369-6116
Mailing Address - Fax:
Practice Address - Street 1:1 COURTHOUSE SQUARE
Practice Address - Street 2:OCHD
Practice Address - City:RHINELANDER
Practice Address - State:WI
Practice Address - Zip Code:54501-0400
Practice Address - Country:US
Practice Address - Phone:715-369-6116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI261-033363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health