Keller, Kelly Renee

Keller, Kelly Renee is an individual health care provider with primary practice located at 411 S Court St , Marion IL 62959-2711. She recently has only one registered license in Nursing Service Providers / School, which is considered as her primary health care specialty. Keller, Kelly Renee can be contacted via phone (618) 993-2138.

Contact Information

Primary practice address
411 S Court St Marion IL 62959-2711
Phone: (618) 993-2138
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / School 163WS0200X 041309727 Illinois

Profile Details

NPI number 1487112918
LBN Legal business name Keller, Kelly Renee
Credentials SCHOOL NURSE
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 4th, 2019
Last updated Mar 4th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487112918 NPPES
Illinois MEDICAID 1902070642

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