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NPI Code Detail

MEDICARE: ALEXA RECHELLE KELLER RN

MEDICARE:   ALEXA RECHELLE KELLER  RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse95263590CA

General Provider Information

NPI Number : 1093475097
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXA RECHELLE KELLER RN
Provider Business Mailing Address
First Line : 1013 SHERMAN ST APT A
Second Line :
City : SAN JOSE
State : CA
Zip : 95110-3149
Country : US
Telephone Number : 408-355-8493
Fax Number :
Provider Business Practice Location Address
First Line : 1013 SHERMAN ST APT A
Second Line :
City : SAN JOSE
State : CA
Zip : 95110-3149
Country : US
Telephone Number : 408-355-8493
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/18/2021
Last Update Date : 12/18/2021

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Directions to “ ALEXA RECHELLE KELLER RN” Practice Location

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