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NPI Code Detail

MEDICARE: MRS. PATRICIA MARIE KEELER A.R.N.P.

MEDICARE:  MRS. PATRICIA MARIE KEELER  A.R.N.P.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerARNP 2029482FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1ARNP 2029482OTHERFLLICENSE NUMBER

General Provider Information

NPI Number : 1376626168
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. PATRICIA MARIE KEELER A.R.N.P.
Provider Business Mailing Address
First Line : 4632 S 25TH ST
Second Line :
City : FORT PIERCE
State : FL
Zip : 34981-5057
Country : US
Telephone Number : 772-464-9595
Fax Number : 772-464-9582
Provider Business Practice Location Address
First Line : 4632 S 25TH ST
Second Line :
City : FORT PIERCE
State : FL
Zip : 34981-5057
Country : US
Telephone Number : 772-464-9595
Fax Number : 772-464-9582
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2006
Last Update Date : 02/17/2011

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Directions to “ MRS. PATRICIA MARIE KEELER A.R.N.P.” Practice Location

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