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General NPI Number Information
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NPI Number | 1598941155
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Entity Type | Organization
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Legal Business Name | JOANNE M KELLER ARNP WOMENS HEALTH & WELLNESS PRACTICE PA
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Dates
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Enumeration Date | 01/14/2008
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Last Update Date | 03/17/2008
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Provider Practice Location Address
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Address Line | 3643 LAKE CENTER DR
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City | MOUNT DORA
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State | FL
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Zip | 32757-2364
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Country | US
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Telephone | 352-385-2631
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Fax | 352-385-2639
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Provider Business Mailing Address
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Address Line | 3643 LAKE CENTER DR
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City | MOUNT DORA
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State | FL
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Zip | 32757-2364
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Country | US
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Telephone | 352-385-2631
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Fax | 352-385-2639
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Authorized Official
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Title or Position | ARNP
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Name | JOANNE M KELLER
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Credential |
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Telephone | 352-385-2631
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3371562
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License Number State | FL
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