Kelli Jean Penrose, P.A., ATC

NPI #1740435551 in Sartell, Minnesota

Provider Information

NPI Number: 1740435551
Entity Type: Individual
Name: Kelli Jean Penrose, P.A., ATC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: P.A., ATC
Enumeration Date: Nov 20, 2008
Last Updated: May 20, 2020

Practice Location

Address: 1901 CONNECTICUT AVE S
City: Sartell
State: Minnesota
ZIP Code: 56377-2554
Phone: (320) 259-4100

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist/Technologist - Athletic Trainer — Athletic Trainer	2255A2300X
Physician Assistant	363A00000X	Primary

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