Provider Demographics
NPI:1437340411
Name:KELLER, LYNN CAMERON (NC)
Entity Type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:CAMERON
Last Name:KELLER
Suffix:
Gender:F
Credentials:NC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:184 PLAZA CIR
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-1650
Mailing Address - Country:US
Mailing Address - Phone:925-683-1239
Mailing Address - Fax:510-580-9429
Practice Address - Street 1:184 PLAZA CIR
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-1650
Practice Address - Country:US
Practice Address - Phone:925-683-1239
Practice Address - Fax:510-580-9429
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education