Keller, Nancy
Keller, Nancy is an sole proprietor health care provider with primary practice located at 790 E 5Th St , Coquille OR 97423-1755. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Keller, Nancy can be contacted via phone (541) 396-3111.Contact Information
Primary practice address
790 E 5Th St
Coquille OR 97423-1755
Phone: (541) 396-3111
Fax: (541) 396-5891
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | MD18038 | Oregon |
Profile Details
| NPI number | 1063496602 |
|---|---|
| LBN Legal business name | Keller, Nancy |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 6th, 2005 |
| Last updated | Mar 23rd, 2010 - about 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063496602 | NPPES |
| Oregon | Other | R0000WFBTV | MEDICARE GROUP PIN NUMBER |
| Oregon | Other | 080041637 | MEDICARE GROUP PIN NUMBER |
| Oregon | Other | CD8723 | MEDICARE GROUP PIN NUMBER |
| Oregon | Other | 1407812365 | MEDICARE GROUP PIN NUMBER |
| Oregon | MEDICAID | 043831 | MEDICARE GROUP PIN NUMBER |
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