| Doctor Name: | LISA KELLER |
| NPI Number: | 1457410540 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CRNP |
| License Number: | SP009116 |
| Business Practice Address: | 3456 Bethlehem Pike Souderton, PA - 189641038 |
| Business Phone Number: | 2157216500 |
| Business Fax Number: | 2157216505 |
| Mailing Address: | 3456 Bethlehem Pike, SOUDERTON |
| State: | PA |
| Postal Code: | 189641038 |
| Phone Number: | 2157216508 |
| Fax Number: | 2157211201 |
| NPI Enumeration Date: | 12/06/2006 |
| NPI Last Update Date: | 06/22/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | SP009116 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |