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Individual

DON LAND KELLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
648 PARK AVE, MONTGOMERY, AL 36106-1837
(334) 294-9342
Mailing address
648 PARK AVE, MONTGOMERY, AL 36106-1837
(334) 294-9342

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
1-091032
AL
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP9226143
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009988575
AL
05
306849800
FL
01
59177497
BLUECROSS BLUESHIELD
AL
01
G3666
BLUECROSS BLUESHIELD
FL
01
P00217034
RAILROAD MEDICARE
FL
Enumeration date
08/15/2005
Last updated
06/27/2013
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