Individual
MS. KRISTINA MARIE KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
980 N MAIN ST, PRINEVILLE, OR 97754
(541) 447-0707
(541) 447-0708
Mailing address
980 N MAIN ST, PRINEVILLE, OR 97754
(541) 447-0707
(541) 447-0708
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
182960
—
OR
01
—
H682402
PACIFIC SOUTH HEALTH PLAN
OR
01
—
H682421
PACIFIC SOUTH HEALTH PLAN
OR
Enumeration date
07/28/2006
Last updated
07/08/2007
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