KATRINA N KELLER (NPI# 1972860815) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972860815 |
| Entity Type | Individual |
| Full Name | KATRINA N KELLER |
| Credential | ARNP |
| Practice Address |
3080 E Gentry Way Meridian ID 83642-3544 |
| Mailing Address |
Po Box 713 Post Falls ID 83877-0713 |
| Practice Telephone | 5095351143 |
| Practice Fax Number | 8664886520 |
| Mailing Telephone | 5095351143 |
| Mailing Fax Number | 8664886520 |
| Enumeration Date | 2012-04-17 |
| Last Update Date | 2020-06-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | AP60284256 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363L00000X | Nurse Practitioner | AP60284256 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
AP60284256 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3080 E GENTRY WAY |
| City | MERIDIAN |
| State | ID |
| Zip Code | 83642-3544 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568466167 | Andrew F Holtz | Family Medicine | 3080 E Gentry Way, Ste 200, Meridian, ID 83642-3544 | 2005-06-10 |
| 1346886777 | Brian Dotter | Pharmacist | 3080 E Gentry Way, Meridian, ID 83642-3544 | 2019-11-20 |
| 1861995102 | Daniel J Allen Do PC | Family Medicine | 3080 E Gentry Way, 100, Meridian, ID 83642-3060 | 2018-03-13 |
| 1922468792 | Alicia Rosales | Social Worker | 3080 E Gentry Way, 202, Meridian, ID 83642-3544 | 2016-03-07 |
| 1558766808 | George Condit II | Massage Therapist | 3080 E Gentry Way, #202, Meridian, ID 83642-3544 | 2014-10-29 |
| 1255676789 | Praxis Medical Group | Internal Medicine | 3080 E Gentry Way, Suite 200, Meridian, ID 83642-3544 | 2012-12-10 |
| 1104055383 | Maria Teresa Gomez Sirucek | Chiropractor | 3080 E Gentry Way, Suite 110, Meridian, ID 83642-3544 | 2009-07-08 |
| 1093975302 | Sirucek Chiropractic Neurology Clinic, Inc. | Chiropractor | 3080 E Gentry Way, Suite 110, Meridian, ID 83642-3544 | 2008-06-10 |
| 1669654935 | Dax Sirucek | Chiropractor | 3080 E Gentry Way, 110, Meridian, ID 83642-3544 | 2007-11-28 |
| 1629022116 | Louis Michael Schlickman | Internal Medicine | 3080 E Gentry Way, Suite 200, Meridian, ID 83642-3013 | 2006-05-20 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174145684 | Ikdo South Meridian LLC | Dentist | 3839 E Amity Rd, Meridian, ID 83642 | 2020-05-07 |
| 1073133328 | Prescription Pad LLC | Pharmacy | 885 S Vanguard Way, Meridian, ID 83642 | 2020-04-16 |
| 1609412683 | Meridian Advanced Psychiatry, LLC | Psychiatry & Neurology | 1672 S Woodsage Ave., Meridan, ID 83642 | 2019-11-25 |
| 1194378927 | Sergey Tsema | Occupational Therapist | 1259 E Pisa St, Meridian, ID 83642 | 2019-07-21 |
| 1003478629 | Chris R Jackson | Dentist | Isu Family Dentistry, 1311 E Central Dr, Meridian, ID 83642 | 2019-07-03 |
| 1285293118 | Morgan Family Medicine | Nurse Practitioner | 1660 S Woodsage Avenue, Meridian, ID 83642 | 2019-06-13 |
| 1033772793 | Nugen Healthcare, Pllc | Registered Nurse | 2177 S Spoonbill Ave, Meridian, ID 83642 | 2019-04-18 |
| 1811471790 | Courtney Crossland | Physician Assistant | 4949 S Hillsdale Ave., Meridian, ID 83642 | 2018-09-18 |
| 1841771938 | Katelyn Perry | Counselor | 2068 S. Eagle Rd., Meridian, ID 83642 | 2018-08-27 |
| 1114406204 | Gem Prep: Meridian LLC | Case Management | 2750 E.gala Ct., Meridian, ID 83642 | 2018-08-09 |
| Find all providers in zip 83642 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710316526 | Courtney Melissa Woolston | Nurse Practitioner | 2112 E Franklin Rd, Meridian, ID 83642-9024 | 2013-11-02 |
| 1992260129 | Anna E Hollingshead | Nurse Practitioner | 1818 College Drive, Meridian, MS 39304 | 2019-02-01 |
| 1457652661 | Julie Joanna Franden | Nurse Practitioner | 4740 N Penngrove Way, Ste 100, Meridian, ID 83646 | 2010-11-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891308094 | Brandon Paul Kruse | Nurse Practitioner | 3345 S Fork Ave, Nampa, ID 83686-4855 | 2020-08-26 |
| 1043838634 | Yendi Labelle | Nurse Practitioner | 1115 N Ironwood Drive, Coeur D'alene, ID 83814 | 2020-07-09 |
| 1558986521 | Lisa Kay Stimpson | Nurse Practitioner | 1605 Poen Rd, Kuna, ID 83634-1743 | 2020-06-15 |
| 1730714049 | Care Medical Housecalls PC | Nurse Practitioner | 2040 E Holgate Ct, Eagle, ID 83616 | 2020-03-06 |
| 1295372308 | Elizabeth Balleweg | Nurse Practitioner | 2306 N 31st St, Boise, ID 83703-5628 | 2019-12-09 |
| 1891264545 | Tina Monique Bossolono-williams | Nurse Practitioner | 1385 Parkview Dr Ste 101, Twin Falls, ID 83301-4084 | 2018-11-23 |
| 1821525452 | Kristin Meshelle Hofmann | Nurse Practitioner | 420 W Main St Ste 206, Boise, ID 83702-7363 | 2017-05-14 |
| 1992237648 | Candice Elaine Adams | Nurse Practitioner | 5108 N Maidstone Way, Boise, ID 83713-1367 | 2017-03-31 |
| 1851832695 | Penny Rea | Nurse Practitioner | 5307 Green Valley Pl, Nampa, ID 83686-5790 | 2017-03-13 |
| 1891176798 | Christine Cooper | Nurse Practitioner | 35 W Idaho St, Weiser, ID 83672 | 2015-06-16 |
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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.