KELLEY E FARNSWORTH


Address: 960 N 12th St, Suite 1800, Milwaukee, WI 53233-1306
Phone: 4142789000

KELLEY E FARNSWORTH (NPI# 1720026339) 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) 1720026339
Entity Type Individual
Full Name KELLEY E FARNSWORTH
Credential PA-C
Practice Address 960 N 12th St
Suite 1800
Milwaukee
WI 53233-1306
Practice Telephone 4142789000
Practice Fax Number 4142789005
Mailing Telephone 4142789000
Mailing Fax Number 4142789005
Enumeration Date 2006-06-04
Last Update Date 2007-10-24
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AS0400X Physician Assistant
Specialization: Surgical Technologist
1051-023 WI Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
WI 42982600 05

Office Location

Street Address 960 N 12TH ST
SUITE 1800
City MILWAUKEE
State WI
Zip Code 53233-1306

Providers in the same location

NPI Name Taxonomy Address Enumeration
1871576256 Kristin Ann Skoraczewski Physician Assistant 960 N 12th St, Suite 1800, Milwaukee, WI 53233-1306 2005-11-21
1518269927 Jessica Tjaden Nurse Practitioner 960 N 12th St, Suite 1800, Milwaukee, WI 53233-1306 2010-11-18
1306939079 Melanie Castle Physician Assistant 960 N 12th St, Suite 1800, Milwaukee, WI 53233-1306 2006-10-02
1992743397 Milwaukee Neurological Institute, Sc Physician Assistant 960 N 12th St, Suite 1800, Milwaukee, WI 53233-1306 2006-06-04
1124071402 Nicholas Knoernschild Physician Assistant 960 N 12th St, Suite 1800, Milwaukee, WI 53233-1306 2006-05-18
1649221516 Joaquin Solis Internal Medicine 960 N 12th St, Suite 400, Milwaukee, WI 53233 2006-05-15
1992774467 Abraham-rami Gal Internal Medicine 960 N 12th St, Suite 400, Milwaukee, WI 53233 2006-03-16
1104893296 Ijaz A Malik Internal Medicine 960 N 12th St, Suite 400, Milwaukee, WI 53233 2006-03-07
1942277587 Heart Care Associates LLC Internal Medicine 960 N 12th St, Suite 400, Milwaukee, WI 53233 2006-03-02
1821065467 Yoseph Shalev Internal Medicine 960 N 12th St, Suite 400, Milwaukee, WI 53233 2006-03-02
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1104454750 Henok Desta Hardilo Student in an Organized Health Care Education/Training Program Aurora Sinai Medical Center 945 N 12th Street, Milwaukee, WI 53233 2020-03-30
1821633314 Ann E Millard Occupational Therapist 560 N. 16th Street, Room 214a, Milwaukee, WI 53233 2019-11-08
1306480918 Teng Kai Ong Dentist 1801 West Wisconsin Ave., Milwaukee, WI 53233 2019-11-06
1356800478 Nebiyu Abera Tilahun Student in an Organized Health Care Education/Training Program Aurora Sinai Medical Center, 945 N. 12th Street, Milwaukee, WI 53233 2019-03-18
1548748387 Emily Claire Goetz Physical Therapist 945 N. 12th St. Suite 1100, Milwaukee, WI 53233 2018-08-03
1801373378 Froedtert & The Medical College of Wisconsin Community Physicians Non-Pharmacy Dispensing Site 1721 W Canal St, Milwaukee, WI 53233 2018-07-26
1184170706 Lauren Troll Physical Therapist 925 N 12th Street, Milwaukee, WI 53233 2016-09-01
1942694401 Iryna Nemesh Internal Medicine 1020 N 12th St Fl 2, Milwaukee, WI 53233 2015-03-23
1649676032 Matina Angelopoulou Dentist 1801 West Winsconsin Ave, Milwaukee, WI 53233 2014-11-12
1780007831 John Ladisa Technician, Other 1637 W. Wisconsin Ave, Room 311, Milwaukee, WI 53233 2014-01-27
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Taxonomy Information

Taxonomy Code 363AS0400X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Surgical Technologist

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1093085664 Abraham David Pacheco Physician Assistant 3246 S 35th St, Milwaukee, WI 53215-4156 2012-01-12
1386603439 Harland L Cook Physician Assistant 2315 M Lake Drive, #703, Milwaukee, WI 53211 2006-03-18
1871576256 Kristin Ann Skoraczewski Physician Assistant 960 N 12th St, Suite 1800, Milwaukee, WI 53233-1306 2005-11-21
1144704677 Jennifer Lynn Vanderpool Physician Assistant 2301 N Lake Dr, Milwaukee, WI 53211-4508 2018-09-20
1528554292 Andrea Rakoczy Physician Assistant 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 2018-07-06
1639665763 Lanie E Rudie Physician Assistant 9200 W Wisconsin Ave, Milwaukee, WI 53226 2018-07-01
1154815298 Aaron Kleinertz Physician Assistant 9200 W Wisconsin Ave, Milwaukee, WI 53226 2018-06-21
1912419953 Krista Chipman Physician Assistant 9000 W Wisconsin Ave, Milwaukee, WI 53226-4874 2017-10-31
1578086468 Benjamin Ingram Physician Assistant 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 2017-07-21
1225481187 Taylor Boyle Physician Assistant 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 2016-07-15
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Competitor

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City MILWAUKEE
Zip Code 53233

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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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