Provider Demographics
NPI:1649328725
Name:KELLER, ROSEMARY B (NP-C)
Entity type:Individual
Prefix:MRS
First Name:ROSEMARY
Middle Name:B
Last Name:KELLER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 HORSESHOE LN
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19465-8573
Mailing Address - Country:US
Mailing Address - Phone:484-300-4119
Mailing Address - Fax:
Practice Address - Street 1:9 GREAT VALLEY PKWY
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-1304
Practice Address - Country:US
Practice Address - Phone:610-889-8312
Practice Address - Fax:610-640-8932
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP009078363LF0000X
VA0024165162363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily