Kelly R Etzel
Debarred entityBorn 19 Apr 1961 (65 years old),United States. Named in 4 sanctions listings.
Sanctions and listings4
- Listed
- 25 Apr 2017
- Effective
- 20 Apr 2017
Reciprocal
HHSUS SAM Procurement ExclusionsUnited StatesActive
Prohibition/Restriction
Excluded by the Department of Health and Human Services pursuant to section 1128 or other sections of the Social Security Act from participation in all Federal health care programs (the scope and effect of Federal health care program exclusions is described in 42 C.F.R. section 1001.1901).
- Effective
- 20 Apr 2017
List of Excluded Individuals/Entities (LEIE)
Department of Health and Human Services Office of Inspector GeneralUS Health and Human Services Inspector General ExclusionsUnited States
1128a4
Programme US-HHS-OIGoig.hhs.govoig.hhs.gov
- Effective
- 20 Apr 2017
Official designation
Montana Department of Public Health & Human ServicesUS Montana Medicaid Excluded and Terminated ProvidersUnited States
- Listed
- 22 Aug 2017
- Effective
- 29 Jun 2017
Positions held1
Period not retained
PHYSICIAN ASSISTANT (IND- LIC HC SERV PRO)
Identifiers1
| Identifier | Number |
|---|---|
| NPI number | 1639285281 |
Addresses2
LOLO, MT 59847
5804 LEGEND LANE, LOLO, MT 59847
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