Healthcare Provider Details

I. General information

NPI: 1396559803
Provider Name (Legal Business Name): VICTORIA KELLER DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/04/2025
Last Update Date: 05/12/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HARPER RD
MONMOUTH JUNCTION NJ
08852-2963
US

IV. Provider business mailing address

2 CAPITAL WAY STE 356
PENNINGTON NJ
08534-2521
US

V. Phone/Fax

Practice location:
  • Phone: 732-841-5954
  • Fax:
Mailing address:
  • Phone: 609-537-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ1573900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: