Keller, Theresa M
Keller, Theresa M is an individual health care provider with primary practice located at 1260 Crossing Meadows Dr , Onalaska WI 54650-8666. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Keller, Theresa M can be contacted via phone (608) 775-5858.Contact Information
Primary practice address
1260 Crossing Meadows Dr
Onalaska WI 54650-8666
Phone: (608) 775-5858
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | A-064032 | Iowa |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 0192371-22 | Minnesota |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 9675 | Wisconsin |
Profile Details
| NPI number | 1851332688 |
|---|---|
| LBN Legal business name | Keller, Theresa M |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 10th, 2006 |
| Last updated | Dec 5th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1851332688 | NPPES |
| Iowa | MEDICAID | 0076372 | |
| Iowa | Other | 01-07133 | |
| Iowa | Other | 47G21KE | |
| Iowa | MEDICAID | 295450800 |
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