MARY JEAN KELLER RN NP NPI 1073678033

NPI Information

NPI: 1073678033
Provider Name: MARY JEAN KELLER, RN, NP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Organization: LESTER E COX MEDICAL CENTERS

PECOS Registration: Yes

Address:
3525 S NATIONAL AVE STE 207
SPRINGFIELD, MO
ZIP 65807
Phone: (417) 269-9220
Get Directions

Mary Jean Keller, RN, NP is a family nurse practitioner in Springfield, MO with 18 years of experience. Mary Jean Keller, RN, NP NPI is 1073678033. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3525 S NATIONAL AVE STE 207
SPRINGFIELD, MO
ZIP 65807-315
Phone: (417) 269-9220
Fax: (417) 269-9229

The NPI 1073678033 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 12/27/2006 and was last updated on 10/23/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	091099	MISSOURI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1073678033	MEDICAID	MISSOURI
2	P00635675	OTHER	MISSOURI	TRAVELERS RR MEDICARE
3	171101758	MEDICAID	ARKANSAS
4	431560263	OTHER	MISSOURI	TRICARE WEST

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »