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Individual

JOANNE M KELLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
3643 LAKE CENTER DR, MOUNT DORA, FL 32757-2364
(352) 385-2631
(352) 385-2639
Mailing address
3643 LAKE CENTER DR, MOUNT DORA, FL 32757-2364
(352) 385-2631
(352) 385-2639

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
3371562
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
304050000
FL
01
Y0232Z
MEDICARE PTAN
FL
Enumeration date
04/17/2006
Last updated
08/20/2010
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