Individual
MRS. LISA JEAN KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D., L.D.
Contact information
Practice address
6160 S YALE AVE, TULSA, OK 74136-1930
(918) 497-3041
(918) 499-3295
Mailing address
6600 S YALE AVE STE 1400, TULSA, OK 74136-3331
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD377
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200434810A
—
OK
Enumeration date
11/02/2006
Last updated
04/27/2022
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