Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Taylor Kellam

Individual provider Physician Assistant · NPI 1740965326

Taylor Kellam is a Physician Assistant in Green Bay, Wisconsin. Qualified in 2025, 1 year ago. Practices as a sole proprietor. Licensed in Wisconsin.

Years since qualifying
1
Licensed in
WI
In the registry since
2023
Specialties on file
2
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Practice location Address checks out

835 S Van Buren St
Green Bay, WI 54301-3526
Phone: (920) 433-0111
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 8441-23 (WI)
Emergency Medicine Physician Taxonomy 207P00000X · Licence 8441-23 (WI)

Record details

NPI number1740965326
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJune 20, 2023
Last updated in NPPESFebruary 10, 2026
Certification dateFebruary 10, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated

Other providers in Green Bay