Provider Information for 1992216618
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Ms. KELLY ANN PEARSON CNP
Sex: Female
Certification Date: 2025-03-14
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1992216618 | ||||||||||||
| Enumeration Date | 2017-10-20 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 335 DALY ST SAINT PAUL, MN 55102-3211 United States Phone: 651-343-4891 | Fax: | ||||||||||||
| Primary Practice Address | 205 WABASHA ST S SAINT PAUL, MN 55107-1805 United States Phone: 952-853-8800 | Fax: | ||||||||||||
| Secondary Practice Address(es) | 2945 HAZELWOOD ST 1801 NICOLLET AVE 15350 ENGLISH AVE 3930 NORTHWOODS DR 8450 SEASONS PKWY 2500 COMO AVE | ||||||||||||
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