Healthcare Provider Details

I. General information

NPI: 1821748500
Provider Name (Legal Business Name): KATHERINE MARGARET KECK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2022
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 UNIVERSITY DR
HERSHEY PA
17033-2360
US

IV. Provider business mailing address

3100 SCHOOLHOUSE RD STE 200
MIDDLETOWN PA
17057-3548
US

V. Phone/Fax

Practice location:
  • Phone: 717-531-8521
  • Fax:
Mailing address:
  • Phone: 717-948-5180
  • Fax: 717-948-0488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberMT236594
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: