Individual
JUSTIN DANIEL KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BSN, RN
Contact information
Practice address
370 E BROAD ST, MALVERN, PA 19355-2506
(610) 241-2444
Mailing address
370 E BROAD ST, MALVERN, PA 19355-2506
(610) 241-2444
Taxonomy
Speciality
Code
Description
License number
State
146L00000X
Paramedic
226652
PA
163W00000X
Registered Nurse
Primary
RN756924
PA
163WE0003X
Emergency Registered Nurse
26NR24419700
NJ
Other
Enumeration date
06/02/2022
Last updated
09/25/2023
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