Individual
KATELYN KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1410 E VILLAGE PKWY, MT ZION, IL 62549-1253
(217) 855-7447
Mailing address
1430 W MOUND RD, DECATUR, IL 62526-1273
(217) 620-3977
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209027622
IL
Other
Enumeration date
08/01/2023
Last updated
08/01/2023
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