Individual
MRS. TIFFANY KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3333 SILAS CREEK PKWY, WINSTON SALEM, NC 27103-3013
(336) 718-5000
Mailing address
3333 SILAS CREEK PKWY, WINSTON SALEM, NC 27103-3013
(336) 718-5000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
5015556
NC
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
287174
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000
N/A
—
Enumeration date
12/28/2021
Last updated
01/03/2022
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