Individual
BRENDA K KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4908 CASS ST, OMAHA, NE 68132-2913
(402) 249-6136
(402) 502-6823
Mailing address
PO BOX 31266, OMAHA, NE 68131-0266
(402) 249-6136
(402) 502-6823
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
18749
NE
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
18749
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10026724400
—
NE
05
—
1962451260
—
IA
05
—
1962451260
—
NE
Enumeration date
05/06/2006
Last updated
08/28/2020
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