Individual
TINA LU KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, MSN, APRN-BC
Contact information
Practice address
11301 WILSHIRE BLVD, 112U, LOS ANGELES, CA 90073-1003
(310) 268-3447
Mailing address
1192 OAK GROVE DR, LOS ANGELES, CA 90041-2418
(323) 254-2751
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
368873
CA
Other
Enumeration date
01/30/2007
Last updated
07/08/2007
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