Individual
BROOKE J KELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
801 BROADWAY N, FARGO, ND 58102-3641
(701) 234-6259
Mailing address
801 BROADWAY N, FARGO, ND 58102-3641
(701) 234-6259
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R42948
ND
Other
Enumeration date
03/24/2016
Last updated
12/02/2019
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