Individual
JENNA KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1430 HIGHWAY 96 E, WHITE BEAR LAKE, MN 55110-3653
(651) 653-2100
(651) 653-2125
Mailing address
8170 33RD AVE S, MS 21110Q, BLOOMINGTON, MN 55425-4516
(651) 653-2100
(651) 653-2125
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
59454
MN
Other
Enumeration date
04/28/2014
Last updated
07/21/2022
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