| Doctor Name: | DR. KIMBERLY EVANS KELLER |
| NPI Number: | 1851426183 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | 4301051409 |
| Business Practice Address: | University Health Services Eastern Michigan University Ypsilanti, MI - 481972207 |
| Business Phone Number: | 7344871122 |
| Business Fax Number: | |
| Mailing Address: | 3768 Barry Knoll Dr, ANN ARBOR |
| State: | MI |
| Postal Code: | 481089406 |
| Phone Number: | 7342130732 |
| Fax Number: | |
| NPI Enumeration Date: | 02/23/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 4301051409 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |