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General NPI Number Information
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NPI Number | 1932601374
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Entity Type | Individual
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Provider Name | JENNIFER ARDELL KELLER NP-C, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 03/01/2018
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 134 ANSLEY DR STE 700
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City | DAHLONEGA
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State | GA
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Zip | 30533-1641
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Country | US
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Telephone | 706-701-5001
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Fax | 706-701-5002
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Provider Business Mailing Address
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Address Line | 571 S ALLEN RD
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City | FLAT ROCK
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State | NC
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Zip | 28731-9447
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Country | US
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Telephone | 828-692-6178
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Fax | 828-692-2365
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RN178949
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN178949
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 382103
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License Number State | NC
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