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Contact Information

KELLI R ROE, P.A.-C
1634 GULL RD
KALAMAZOO, MI49048-1632
 Phone: 269-903-2835
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgical

363AS0400X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for KELLI R ROE · (Female)

NPI # 1225318751
Status Active
Credentials P.A.-C
Entity Individual
Enumeration date 08/29/2011
Last updated 03/02/2016 - About 10 years ago
Sole proprietor 1 No
Identifiers
  • MI License # 5601006123
  • MI Medicaid 1225318751
  • MI Other 1417961137 BCBSM - BMH
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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