Healthcare Provider Details

I. General information

NPI: 1144545633
Provider Name (Legal Business Name): WILLIAM KEFFER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2010
Last Update Date: 03/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 S FRONT ST
HARRISBURG PA
17104-1621
US

IV. Provider business mailing address

PO BOX 1855
HARRISBURG PA
17105-1855
US

V. Phone/Fax

Practice location:
  • Phone: 717-221-6200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN502963L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: