Keller, Mary Jean

Keller, Mary Jean is an individual health care provider with primary practice located at Mary Keller 785 Elkridge Landing Suite #300, Linthicum Heights MD 21090. 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, Mary Jean can be contacted via phone (417) 379-7253.

Contact Information

Primary practice address
Mary Keller 785 Elkridge Landing Suite #300 Linthicum Heights MD 21090
Phone: (417) 379-7253
Fax: (844) 464-0583
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 091099 Missouri

Profile Details

NPI number 1073678033
LBN Legal business name Keller, Mary Jean
Credentials RN, NP
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 27th, 2006
Last updated Jun 10th, 2024 - about 5 months 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 1073678033 NPPES
Missouri Other P00635675 TRAVELERS RR MEDICARE
Missouri MEDICAID 171101758 TRAVELERS RR MEDICARE
Missouri MEDICAID 1073678033 TRAVELERS RR MEDICARE
Missouri Other 431560263 TRAVELERS RR MEDICARE

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