Kelly Nicole Siverhus, PA-C, MS, RDN, CD is a
Physician Assistant based in Milwaukee, Wisconsin. Kelly Nicole Siverhus is licensed to practice in Wisconsin (license number 8121-23) and her current practice location is
9200 W Wisconsin Ave, Milwaukee, Wisconsin. She can be reached at her office (for appointments etc.) via phone at
(414) 805-7782.
NPI number for Kelly Nicole Siverhus is 1972269876 and her current mailing address is 9200 W Wisconsin Ave, Milwaukee, Wisconsin. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1972269876.
Healthcare Provider's Profile
Full Name | Kelly Nicole Siverhus |
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Gender | Female |
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Speciality | Physician Assistant |
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Location | 9200 W Wisconsin Ave, Milwaukee, Wisconsin |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1972269876
- Provider Enumeration Date: 11/15/2021
- Last Update Date: 09/29/2024
Medical Identifiers
Medical identifiers for Kelly Nicole Siverhus such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1972269876 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
133V00000X | Dietitian, Registered | 3755-29 (Wisconsin) | Secondary |
363A00000X | Physician Assistant | 8121-23 (Wisconsin) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kelly Nicole Siverhus is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Kelly Nicole Siverhus, PA-C, MS, RDN, CD 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 Ph: (414) 805-7782 | Kelly Nicole Siverhus, PA-C, MS, RDN, CD 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 Ph: (414) 805-7782 |
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