LYNN SECUNDE KELLER (NPI# 1124512850) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124512850 |
| Entity Type | Individual |
| Full Name | LYNN SECUNDE KELLER |
| Credential | NP |
| Practice Address |
1477 Patton Dr Boulder CO 80303-1258 |
| Practice Telephone | 7209898181 |
| Mailing Telephone | 7209898181 |
| Enumeration Date | 2018-06-16 |
| Last Update Date | 2018-06-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WG0000X |
Registered Nurse Specialization: General Practice |
130914 | CO | Nursing Service Providers |
| N | 163WM1400X |
Registered Nurse Specialization: Nurse Massage Therapist (NMT) |
130914 | CO | Nursing Service Providers |
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
F302220-1 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY LICENSE | F302220-1 | 01 | |
| CO | RN LICENSE | RN-130914 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 103 W Seneca St Ste 304, Ithaca, NY 148504145 | 7209898181 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437340411 | Lynn Cameron Keller | Nutritionist | 184 Plaza Cir, Danville, CA 94526-1650 | 2007-08-06 |
| 1033628201 | Lynn P Keller | Nurse Practitioner | 311 W Fairchild St, Danville, IL 61832-3876 | 2017-09-20 |
| Street Address |
1477 PATTON DR |
| City | BOULDER |
| State | CO |
| Zip Code | 80303-1258 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821583725 | Ariel Meyers | Physical Therapist | Frasier Meadows Retirement Community Dept. of Rehab, 350 Ponca Place, Boulder, CO 80303 | 2018-06-25 |
| 1831683838 | Sandra Ramsey | Occupational Therapist | 350 Ponca, Boulder, CO 80303 | 2018-06-22 |
| 1770085243 | Laura Michelle Boucher | Physical Medicine & Rehabilitation | 5387 Manhattan Cir, Ste 200, Boulder, CO 80303 | 2018-03-01 |
| 1396255568 | Colorado Sports Chiropractic | Chiropractor | 1440 28th St Ste 2, Boulder, CO 80303 | 2017-10-02 |
| 1932618782 | Michele Adrienne Packard | Psychologist | 4410 Arapahoe Suite 140, Boulder, CO 80303 | 2017-09-25 |
| 1134505290 | Bili Blanket Baby, LLC | Durable Medical Equipment & Medical Supplies | 4450 Arapahoe Ave, Suite 100, Boulder, CO 80303 | 2015-07-30 |
| 1710378146 | Jonathan Gardiner Lears | Counselor | 5600 Arapahoe Ave, Suite 102, Boulder, CO 80303 | 2015-02-06 |
| 1114316965 | Northstar Transitions | Substance Abuse Rehabilitation Facility | 75 Manhattan Dr., Suites 110 and 208 Northstar Transitions, Boulder, CO 80303 | 2015-01-16 |
| 1902226434 | Integrated Dermatology of Boulder, Pllc | Dermatology | 2935 Baseline Road, Suite 201, Boulder, CO 80303 | 2014-04-23 |
| 1396160081 | Melissa Rupert | Physical Therapist | 975 Waite Drive, Boulder, CO 80303 | 2014-03-04 |
| Find all providers in zip 80303 | ||||
| Taxonomy Code | 163WG0000X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679184402 | Sharon Louise Barefoot | Registered Nurse | 614 Tantra Dr, Boulder, CO 80305-6161 | 2020-08-14 |
| 1871793448 | Veronica P Dotterweich | Registered Nurse | 2750 Broadway, Boulder, CO 80304 | 2007-07-23 |
| 1104349711 | Wendi Johnson Stewart | Registered Nurse | 3482 Broadway St, Boulder, CO 80304-1824 | 2017-07-25 |
| 1487893509 | Lynn Janet Kimball | Registered Nurse | 4745 Arapahoe Ave, Suite 310, Boulder, CO 80303-1080 | 2009-02-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356957906 | Julie Elizabeth Jacobsen | Registered Nurse | 24151 Road S.8, Dolores, CO 81323-9135 | 2020-09-18 |
| 1649804758 | Patrick G Keebey | Registered Nurse | 1974 Lake Forest Cir, Pagosa Springs, CO 81147-9392 | 2020-02-27 |
| 1326671413 | Laura Ann Doyle | Registered Nurse | 8775 County Road 80.5 # 5, Fort Collins, CO 80524 | 2020-02-17 |
| 1417592114 | Integrated Psychiatric Services LLC | Registered Nurse | 2646 Patterson Rd, Ste B, Grand Junction, CO 81506-1994 | 2019-11-17 |
| 1487299228 | Rosalee Reinke | Registered Nurse | 3633 N York St, Denver, CO 80205-3543 | 2019-11-15 |
| 1720645476 | Heather Marie Raney | Registered Nurse | 1252 Nightfire Cir, Castle Rock, CO 80104-7706 | 2019-05-28 |
| 1780156885 | Edna Aquino Aguila De La Cruz | Registered Nurse | 3002 Baltimore Ave, Pueblo, CO 81008-1366 | 2018-12-30 |
| 1104328590 | Jane Cartwright Winter | Registered Nurse | 8945 W 67th Ave, Arvada, CO 80004-3009 | 2018-03-02 |
| 1831606227 | Cynthia L Bogacki | Registered Nurse | 2300 S Rock Creek Pkwy Apt 14-101, Superior, CO 80027-4414 | 2018-01-07 |
| 1568977288 | Alicia Ann Jones | Registered Nurse | 250 Max Dr Ste 102, Castle Pines, CO 80108-9518 | 2017-12-04 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.