Individual
MRS. KIM MARIE KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
444 BRUCE ST, YREKA, CA 96097-3450
(530) 842-4121
Mailing address
444 BRUCE ST, YREKA, CA 96097-3450
(530) 841-2049
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
95044509
CA
Other
Enumeration date
02/07/2018
Last updated
02/07/2018
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