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Contact Information

ALYSSA KETTLER
640 JACKSON ST # T
SAINT PAUL, MN55101-2502
 Phone: 651-254-3456
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
 

Pediatric Emergency Medicine

207PP0204X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for ALYSSA KETTLER · (Female)

NPI # 1518594092
Status Active
Credentials
Entity Individual
Enumeration date 03/25/2020
Last updated 08/18/2025 - About 10 months ago
Sole proprietor 1 No
Identifiers
  • CA License # A187029
  • MN License # 78809
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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