Provider Demographics
NPI:1447804216
Name:KELLER, AIMEE ELIZABETH FOSTER (MS, FNP-BC)
Entity type:Individual
Prefix:
First Name:AIMEE
Middle Name:ELIZABETH FOSTER
Last Name:KELLER
Suffix:
Gender:F
Credentials:MS, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 SECOND AVE STE 520
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451-1142
Mailing Address - Country:US
Mailing Address - Phone:781-487-6000
Mailing Address - Fax:781-487-2978
Practice Address - Street 1:52 SECOND AVE STE 520
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02451-1142
Practice Address - Country:US
Practice Address - Phone:781-487-6000
Practice Address - Fax:781-487-2978
Is Sole Proprietor?:No
Enumeration Date:2019-07-30
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2274206163W00000X, 363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily