Individual
SAMANTHA KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDM
Contact information
Practice address
2650 E BROADVIEW AVE, WASILLA, AK 99654-8302
(907) 373-3420
Mailing address
2650 E BROADVIEW AVE, WASILLA, AK 99654-8302
(907) 373-3420
Taxonomy
Speciality
Code
Description
License number
State
175M00000X
Lay Midwife
Primary
76
AK
Other
Enumeration date
03/05/2015
Last updated
03/05/2015
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