Individual
JESSICA SUE KELLERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
353 FAIRMONT BLVD, RAPID CITY, SD 57701-7375
(605) 644-4431
Mailing address
353 FAIRMONT BLVD, RAPID CITY, SD 57701-7375
(605) 755-8107
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
CP001318
SD
363LA2100X
Acute Care Nurse Practitioner
CP001318
SD
Other
Enumeration date
12/06/2017
Last updated
01/24/2020
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