Individual ProviderKelly Ann CallisNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address9900 Bren Rd E, Minnetonka, MN 55343-9664(941) 725-2171PECOS EnrollmentBased on the most recent information from CMS, provider Kelly Ann Callis does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1033610100Provider TypeIndividualFull NameCallis, Kelly AnnTitleMrs.CredentialARNP FNP-CGenderFemaleSole ProprietorNoEnumeration Date2/23/2018Last Updated6/26/2020Contact InformationPractice LocationPractice Address9900 Bren Rd E, Minnetonka, MN 55343-9664Phone(941) 725-2171FaxUnlisted FaxMailing LocationMailing Address812 60th St NW, Bradenton, FL 34209-1407Phone(941) 725-2171FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363L00000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseARNP9311654FloridaCode363LF0000XDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense9311654Florida