Kim Lynne Keller, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LP00037551 Issued in WA

Practice address

9610 168TH Street CT E
Puyallup, WA 98375-2256

Phone

(253) 840-8881

Fax

(253) 840-8992

NPI assigned

Jan 4, 2013

Last updated

Jan 4, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1357257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357257600000",
    "number": "1902143324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 2ND ST SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723220",
            "telephone_number": "253-840-8881",
            "fax_number": "253-840-8992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9610 168TH STREET CT E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983752256",
            "telephone_number": "253-840-8881",
            "fax_number": "253-840-8992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "KIM",
        "middle_name": "LYNNE",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-04",
        "last_updated": "2013-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WA",
            "license": "LP00037551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• KC Care, LLC (BrightStar Care of Puyallup)
• Kari Keane
• Joshua Ikaika Keanu, PA-C
• Matthew Keen, RD
• Rebekka Kehlenbrink
• Tonya Kellerman
• Julia Elizabeth Kelley, FNP
• Kellie Eleazer
• Shannon Kelsch, AAHCC
• Paige Elizabeth Kelso-Znak, MSW

• Licensed Practical Nurse in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Licensed Practical Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.