Individual
LORI SUE KELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
15255 N 40TH ST STE 135, PHOENIX, AZ 85032-4682
(480) 417-5289
Mailing address
1220 E TREMAINE AVE, GILBERT, AZ 85234-4879
(480) 849-6255
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
227099
AZ
Other
Enumeration date
07/15/2019
Last updated
02/07/2022
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