Healthcare Provider Details

I. General information

NPI: 1023332723
Provider Name (Legal Business Name): SHEILA A KEASLER CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2010
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 OLD TREE CT
SIMPSONVILLE SC
29681
US

IV. Provider business mailing address

7 OLD TREE CT
SIMPSONVILLE SC
29681
US

V. Phone/Fax

Practice location:
  • Phone: 850-212-6603
  • Fax:
Mailing address:
  • Phone: 850-212-6603
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number17661
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number259703
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1184
License Number StateNC
# 4
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number19001
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: