Doctor Name: | KELLY JARCHO |
NPI Number: | 1548515976 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | F-PMHNP |
License Number: | R180187-1 |
Business Practice Address: | 100 Freeman Dr Saint Peter, MN - 560823504 |
Business Phone Number: | 2187801410 |
Business Fax Number: | |
Mailing Address: | 100 Freeman Dr, SAINT PETER |
State: | MN |
Postal Code: | 560823504 |
Phone Number: | 2187801410 |
Fax Number: | |
NPI Enumeration Date: | 07/23/2012 |
NPI Last Update Date: | 04/02/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0808X |
License Number: | R180187-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |