Healthcare Provider Details

I. General information

NPI: 1962317958
Provider Name (Legal Business Name): CHRISTINA LOUISE KELLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2026
Last Update Date: 08/15/2026
Certification Date: 08/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 6TH AVE NW
TOWNER ND
58788-4212
US

IV. Provider business mailing address

306 6TH AVE NW
TOWNER ND
58788-4212
US

V. Phone/Fax

Practice location:
  • Phone: 701-720-4624
  • Fax:
Mailing address:
  • Phone: 701-720-4624
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: