Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0011X | Interventional Cardiology | 35076994W | OH |
NPI | 1073576294 |
---|---|
Provider Name | Jennifer L Keller |
First Address | Marion, OH 43302-6347 |
Second Address | Chillicothe, OH 45601-7065 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2006 |
Last Update Date | 06/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
*31244 | (02) | |
0000000362663 | ANTHEM BCBS (01) | |
133184 | NATIONWIDE INSURANCE (01) | |
2547680 | UNITED HEALTHCARE (01) | |
2595115 | (05) | OH |
PO0244309 | RAILROAD MEDICARE (01) |