Individual provider · Type 1 NPI
Kelly Theodore, PMHNP, FNP
Psychiatric/Mental Health Nurse Practitioner · Milwaukee, WI
NPI number
1821472226
Active
Practice location
111 E Wisconsin Ave Ste 1500
Milwaukee, WI 53202-4808
Mailing address
4800 N Scottsdale Rd Ste 2500
Scottsdale, AZ 85251-7630
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 6467 (WI) |
| Nurse Practitioner | 363L00000X | 6467 (WI) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1821472226
Kelly Theodore, PMHNP, FNP's National Provider Identifier is 1821472226, issued on Jul 15, 2015. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Milwaukee, WI. The record was last updated on May 22, 2026.