Healthcare Provider Details

I. General information

NPI: 1790286748
Provider Name (Legal Business Name): KARA ANNE KEYES PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2018
Last Update Date: 02/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3007 N SAGINAW RD
MIDLAND MI
48640-4555
US

IV. Provider business mailing address

1265 E MILLER RD
MIDLAND MI
48640-8941
US

V. Phone/Fax

Practice location:
  • Phone: 989-633-1400
  • Fax:
Mailing address:
  • Phone: 989-600-2560
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: