| Doctor Name: | MRS. MARYE KELLERMANN |
| NPI Number: | 1063623866 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CRNP |
| License Number: | RO56576 |
| Business Practice Address: | 31 Blondell Ct Lutherville, MD - 210932003 |
| Business Phone Number: | 4104940398 |
| Business Fax Number: | 4104941445 |
| Mailing Address: | 31 Blondell Ct, LUTHERVILLE |
| State: | MD |
| Postal Code: | 210932003 |
| Phone Number: | 4104940398 |
| Fax Number: | 4104941445 |
| NPI Enumeration Date: | 05/24/2007 |
| NPI Last Update Date: | 03/10/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | RO56576 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |