KELLI ANN POLUM


Address: 1122 W Highway 61, Winona, MN 55987-1957
Phone: 6087827300

KELLI ANN POLUM (NPI# 1184275794) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1184275794
Entity Type Individual
Full Name KELLI ANN POLUM
Credential PHYSICIAN ASSISTANT
Practice Address 1122 W Highway 61
Winona
MN 55987-1957
Mailing Address 1836 South Ave
La Crosse
WI 54601-5429
Practice Telephone 6087827300
Mailing Telephone 6087827300
Enumeration Date 2019-09-25
Last Update Date 2020-07-21
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 363AM0700X Physician Assistant
Specialization: Medical
4850 WI Physician Assistants & Advanced Practice Nursing Providers
Y 363AM0700X Physician Assistant
Specialization: Medical
13360 MN Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 1122 W HIGHWAY 61
City WINONA
State MN
Zip Code 55987-1957

Providers in the same location

NPI Name Taxonomy Address Enumeration
1811974801 Cindy Lynn Gile Physician Assistant 1122 W Highway 61, Winona, MN 55987-1957 2005-12-29
1992311591 David Witkiewicz Pharmacist 1122 W Highway 61, Winona, MN 55987-1957 2020-09-18
1952959603 Gundersen Lutheran Medical Center Inc Clinic/Center 1122 W Highway 61, Winona, MN 55987-1957 2019-08-27
1083969398 Kelly Rae Hebl Garcia Nurse Practitioner 1122 W Highway 61, Winona, MN 55987-1957 2012-07-24
1154439487 Neil H Tator Physician Assistant 1122 W Highway 61, Winona, MN 55987-1957 2006-08-27
1295754463 Katy S Anthony Physician Assistant 1122 W Highway 61, Winona, MN 55987-1957 2006-07-19
1134160492 Vivian R Rider Pediatrics 1122 W Highway 61, Winona, MN 55987-1957 2006-06-09
1376596536 Jonathan Edward Knight Family Medicine 1122 W Highway 61, Winona, MN 55987-1957 2006-05-18

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1891277232 Jamie Sanders Social Worker 51 East 4th St Suite 307, Winona, MN 55987 2018-09-01
1841727823 Stacey A Czaplewski Specialist/Technologist 175 West Mark Street, Winona State University-139 Memorial Hall, Winona, MN 55987 2017-05-22
1083145361 Kevin Lee Knack Counselor 902 E. Second St. Suite 326, Acumen Counseling, Winona, MN 55987 2017-03-27
1467993865 Melissa Lee Peterson Specialist/Technologist 23559 Co. Rd. 20, Winona, MN 55987 2017-03-17
1790226280 Nikolas Porter Lyon Specialist/Technologist 634 Franklin St, East Lake B 306-4, Winona, MN 55987 2017-03-16
1821424953 Sara Beth Borchardt Chiropractor 1423 West Service Drive, Winona, MN 55987 2013-09-20
1952614273 Kristin Janelle Noble Chiropractor 117 W. 3rd St., Winona, MN 55987 2010-07-15
1033435615 Christine E. Clark Pharmacist 1122 Hwy 61, Winona, MN 55987 2010-04-08
1346401544 Andrew Dean Mork Dentist 50 W Second Street, Winona, MN 55987 2008-06-19
1508073693 Lawrence J Green Psychologist 61 W 4th St, Winona, MN 55987 2007-05-17
Find all providers in zip 55987

Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1811974801 Cindy Lynn Gile Physician Assistant 1122 W Highway 61, Winona, MN 55987-1957 2005-12-29
1396110516 Kara Kristine Reller Physician Assistant 420 E Sarnia St, Winona, MN 55987-6365 2015-12-14
1841671500 Stephanie Frisch Lewis Physician Assistant 855 Mankato Ave, Winona, MN 55987-4868 2015-06-17
1720374663 Denver Todd Brown Physician Assistant 855 Mankato Ave, Winona, MN 55987-4868 2011-06-20
1154439487 Neil H Tator Physician Assistant 1122 W Highway 61, Winona, MN 55987-1957 2006-08-27
1003836701 Roosevelt Smith Jr. Physician Assistant 62 E 3rd St, Suite 3, Winona, MN 55987-3481 2006-07-19

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1255969150 Isaac Waalen Physician Assistant 5420 Circle Down, Minneapolis, MN 55416-1312 2020-03-28
1730643701 Christina Jones Physician Assistant 11850 Blackfoot St Nw Ste 270, Coon Rapids, MN 55433-2593 2019-01-24
1114492964 Molly Goss Physician Assistant 1817 Sunset Dr, Northfield, MN 55057-3246 2018-10-09
1932600160 Ellen Kathryn Freeman Physician Assistant 111 Hundertmark Rd Ste 480, Chaska, MN 55318-1485 2018-02-22
1174041875 Kristen Webb Physician Assistant 3931 Louisiana Ave S, Suite E-500, St. Louis Park, MN 55426 2017-09-01
1073051751 Hannah Elizabeth Rosenthal Danielson Physician Assistant 640 Jackson St # Ms 11102m, Saint Paul, MN 55101 2017-02-02
1457893984 Daniel Ryan Nguyen Physician Assistant 14551 Co Rd #11 #100, Burnsville, MN 55337 2016-11-15
1538545686 Kathryn Jelle Physician Assistant 3931 Louisiana Ave S # 55426, St Louis Park, MN 55426-5000 2015-07-30
1831503267 Karrah Oliver Physician Assistant 205 Roosevelt Ave W, Karlstad, MN 56732-4022 2014-06-13
1477981777 Melissa Ferraz De Toledo Physician Assistant 9145 Springbrook Dr Nw Ste 300, Coon Rapids, MN 55433-5897 2013-10-23
Find all providers with the same taxonomy

Competitor

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City WINONA
Zip Code 55987

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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