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Individual

MRS. JENNIFER KELLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APN

Contact information

Practice address
5590 KIETZKE LN, RENO, NV 89511-3019
(775) 323-2080
(775) 323-8216
Mailing address
5590 KIETZKE LN, RENO, NV 89511-3019
(775) 323-2080
(775) 323-8216

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
TAPN700791
NV
363LF0000X
Family Nurse Practitioner
Primary
APN001408
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
APN001408
STATE LICENSE
NV
01
TAPN700791
TAPN
NV
Enumeration date
06/29/2012
Last updated
03/25/2019
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