Individual
KATIE KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1500 S LAKE PARK AVE STE 110, HOBART, IN 46342-6638
(219) 947-6017
Mailing address
1500 S LAKE PARK AVE STE 110, HOBART, IN 46342-6638
(219) 947-6017
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28197355A
IN
363LF0000X
Family Nurse Practitioner
Primary
71008713A
IN
Other
Enumeration date
12/10/2018
Last updated
01/28/2019
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