Individual
COURTNEY KELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1728 W BLUEWATER HWY, IONIA, MI 48846-8553
(616) 527-3100
Mailing address
1728 W BLUEWATER HWY, IONIA, MI 48846-8553
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704395945
MI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704395945
MI
Other
Enumeration date
11/08/2021
Last updated
05/28/2025
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