Individual ProviderBrett Andrew KellyStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address1801 W Wisconsin Ave, Milwaukee, WI 53233-2186(219) 776-9378PECOS EnrollmentBased on the most recent information from CMS, provider Brett Andrew Kelly 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 yesterday at 12:57 PM.Profile DetailsProvider ID1033775127Provider TypeIndividualFull NameKelly, Brett AndrewGenderMaleSole ProprietorNoEnumeration Date5/14/2019Last Updated5/14/2019Contact InformationPractice LocationPractice Address1801 W Wisconsin Ave, Milwaukee, WI 53233-2186Phone(219) 776-9378FaxUnlisted FaxMailing LocationMailing Address1801 W Wisconsin Ave, Milwaukee, WI 53233-2186Phone(219) 776-9378FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer