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Individual

LAURA KELLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
560 MAIN STREET, WEAVERVILLE, CA 96093
(530) 623-3735
(530) 623-1196
Mailing address
PO BOX 2460, 560 MAIN STREET, WEAVERVILLE, CA 96093-2460
(530) 623-3735
(530) 623-1196

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
8729
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
RN476117
CA
Enumeration date
07/19/2006
Last updated
10/02/2013
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