=====================================================
General NPI Number Information
=====================================================
NPI Number | 1396559803
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | VICTORIA KELLER DNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/04/2025
-----------------------------------------------------
Last Update Date | 05/12/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1 HARPER RD
-----------------------------------------------------
City | MONMOUTH JUNCTION
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08852-2963
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-841-5954
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2 CAPITAL WAY STE 356
-----------------------------------------------------
City | PENNINGTON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08534-2521
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 609-537-6000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 26NJ1573900
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------