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Individual

JENNIFER E. KELLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
1252 N 22ND ST UNIT A, LARAMIE, WY 82072
(307) 745-5364
Mailing address
205 CORTHELL RD, LARAMIE, WY 82070-4827
(307) 399-7133

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
336651808
WY
363LF0000X
Family Nurse Practitioner
Primary
33665.1808
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
33665.1808
WYOMING STATE BOARD OF NURSING
WY
Enumeration date
07/16/2014
Last updated
01/30/2019
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