Healthcare Provider Details

I. General information

NPI: 1760245443
Provider Name (Legal Business Name): KELSEY MICHAELS PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KELSEY HUNT HUNT

II. Dates (important events)

Enumeration Date: 02/05/2024
Last Update Date: 01/29/2026
Certification Date: 01/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

331 E PUETZ RD # 100
OAK CREEK WI
53154-3254
US

IV. Provider business mailing address

7330 W LAYTON AVE
MILWAUKEE WI
53220-3849
US

V. Phone/Fax

Practice location:
  • Phone: 406-441-4296
  • Fax:
Mailing address:
  • Phone: 414-877-4570
  • Fax: 414-817-8940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number15819
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number15819
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License Number260902
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: