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General NPI Number Information
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NPI Number | 1003176645
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Entity Type | Individual
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Provider Name | MARY KEELEY CPM
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Gender | Female
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Dates
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Enumeration Date | 05/16/2012
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Last Update Date | 08/23/2019
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Provider Practice Location Address
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Address Line | 3506 COUNTRYSIDE LN
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City | CAMP HILL
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State | PA
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Zip | 17011-1520
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Country | US
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Telephone | 304-258-9504
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Fax | 717-790-2747
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Provider Business Mailing Address
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Address Line | 3506 COUNTRYSIDE LN
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City | CAMP HILL
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State | PA
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Zip | 17011-1520
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Country | US
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Telephone | 304-258-9504
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Fax | 717-790-2747
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number |
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License Number State |
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