Healthcare Provider Details

I. General information

NPI: 1881500858
Provider Name (Legal Business Name): KAREN SUE KEITH APN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 OOLOGILA PL
LOUDON TN
37774-6923
US

IV. Provider business mailing address

200 OOLOGILA PL
LOUDON TN
37774-6923
US

V. Phone/Fax

Practice location:
  • Phone: 248-808-2248
  • Fax: 865-458-4277
Mailing address:
  • Phone: 248-808-2248
  • Fax: 865-458-4277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number11649
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: