| NPI | 1245692318 |
|---|---|
| Former Name | LASHANDA MARIE KELLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP129888) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN199448) |
| Enumeration Date | 2016-03-28 |
| Last Update Date | 2017-02-02 |