Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 5324349-1205 | UT |
N | 207R00000X | Internist | 5323439-1205 | UT |
N | 111NI0900X | Internist | 5323439-1205 | UT |
NPI | 1225202260 |
---|---|
Provider Name | Dr. Allison Anne Keller |
First Address | Salt Lake City, UT 84158-1289 |
Second Address | Salt Lake City, UT 84108-1220 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2008 |
Last Update Date | 20/12/2021 |