Individual
MS. EMILY PAIGE KELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2001 RANDOLPH RD, CHARLOTTE, NC 28207-1215
(704) 323-2225
Mailing address
4601 PARK RD STE 300, CHARLOTTE, NC 28209-2290
(704) 323-2090
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-12379
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0397730007
NSC #
NC
Enumeration date
11/08/2022
Last updated
11/18/2022
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