Healthcare Provider Details

I. General information

NPI: 1700332210
Provider Name (Legal Business Name): KAILEY M LEDO PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAILEY M SCHELLER PA

II. Dates (important events)

Enumeration Date: 08/26/2016
Last Update Date: 04/18/2025
Certification Date: 04/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

265 GRIFFIN ST E
AMERY WI
54001-1439
US

IV. Provider business mailing address

200 1ST ST SW
ROCHESTER MN
55905-0001
US

V. Phone/Fax

Practice location:
  • Phone: 715-268-8000
  • Fax:
Mailing address:
  • Phone: 507-284-2511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number3888
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: