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Individual

JENNIFER KELLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
777 MURPHY RD, MEDFORD, OR 97504-8425
(541) 772-2726
Mailing address
800 ELLENDALE DR, APT. 13, MEDFORD, OR 97504-8211
(951) 293-6477

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
201604987LPN
OR

Other

Enumeration date
01/24/2017
Last updated
01/24/2017
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