NPI Profile for JAMIE L KETTERMAN in CLINTON, MO.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Family |
363LF0000X | 50 | Nurse Practitioner | |
Diabetes Educator |
163WD0400X |
| NPI Number | 1609087402 |
|
| Status | Active | |
| Credentials | RN, BSN, CDE | |
| Entity | Individual | |
| Enumeration date | 05/24/2007 | |
| Last updated | 11/16/2021 - About 5 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
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| Hospital affiliation(s) |
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JAMIE L KETTERMAN
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