Individual
AUDREY LYNN KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
525 4TH ST, BALDWIN, MI 49304-9518
(231) 745-3116
(231) 745-3136
Mailing address
525 4TH ST, BALDWIN, MI 49304-9518
(231) 745-3116
(231) 745-3136
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
CO2225
CO
363A00000X
Physician Assistant
22536
CA
363A00000X
Physician Assistant
Primary
5601005193
MI
Other
Enumeration date
10/25/2006
Last updated
12/29/2014
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