Individual provider · Type 1 NPI

Jessie Marie Kellogg

Psychiatric/Mental Health Nurse Practitioner · Tomah, WI

NPI number 1508579103 Active

Practice location

500 E Veterans St
Tomah, WI 54660-3105

Mailing address

412 Mccaul St
Tomah, WI 54660-1844

Specialties and licenses

TaxonomyCodeLicense
Psychiatric/Mental Health Nurse Practitioner Primary 363LP0808XG172333 (IA)

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

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About NPI 1508579103

Jessie Marie Kellogg's National Provider Identifier is 1508579103, issued on Dec 29, 2022. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Tomah, WI. The record was last updated on Dec 29, 2022.