Healthcare Provider Details

I. General information

NPI: 1588909402
Provider Name (Legal Business Name): KELLI DANIELLE CULVER APRN, NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KELLI GRENZ

II. Dates (important events)

Enumeration Date: 12/04/2012
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

216 3RD ST W STE 201
ASHLAND WI
54806
US

IV. Provider business mailing address

216 3RD ST W STE 201
ASHLAND WI
54806-1659
US

V. Phone/Fax

Practice location:
  • Phone: 715-685-0656
  • Fax:
Mailing address:
  • Phone: 715-685-0656
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number956933
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number956933
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number486
License Number StateMN
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2227496
License Number StateMN
# 5
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number25001130
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: