Individual
ALAN MARK KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNAP
Contact information
Practice address
3901 RAINBOW BLVD, KANSAS CITY, KS 66160
(913) 588-5000
Mailing address
3386 W FORSYTHIA DR, BOISE, ID 83703-4751
(913) 909-6040
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
13-121632-081
KS
367500000X
Certified Registered Nurse Anesthetist
43-557602-081
KS
367500000X
Certified Registered Nurse Anesthetist
Primary
65445
ID
Other
Enumeration date
05/03/2018
Last updated
10/14/2020
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