Provider Demographics
NPI:1801850219
Name:KEELER, ELSA N (MD)
Entity Type:Individual
Prefix:
First Name:ELSA
Middle Name:N
Last Name:KEELER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:8170 33RD AVE S
Mailing Address - Street 2:MS21110Q
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:952-883-5375
Mailing Address - Fax:651-532-2111
Practice Address - Street 1:1430 HWY 96 E
Practice Address - Street 2:HEALTHPARTNERS WHINE BEAR LAKE CLINIC-MAIL STOP 32300A
Practice Address - City:WHITE BEAR LAKE
Practice Address - State:MN
Practice Address - Zip Code:55110-7693
Practice Address - Country:US
Practice Address - Phone:651-426-1980
Practice Address - Fax:651-653-2111
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2011-12-27
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Provider Licenses
StateLicense IDTaxonomies
MN34028208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN119207800Medicaid
E99249Medicare UPIN
MN370002115Medicare ID - Type Unspecified