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General NPI Number Information
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NPI Number | 1043988108
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Entity Type | Individual
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Provider Name | KEIFE EARLEY
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Gender | Male
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Dates
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Enumeration Date | 09/02/2021
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 104 NORTH PARK DRIVE
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City | MONROE
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State | LA
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Zip | 71203-7158
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Country | US
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Telephone | 318-600-3456
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Fax | 318-374-6828
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Provider Business Mailing Address
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Address Line | 104 NORTH PARK DRIVE
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City | MONROE
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State | LA
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Zip | 71203-7158
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Country | US
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Telephone | 318-600-3456
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Fax | 318-600-3364
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 71012944A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | C-RXN.0002269-C-NP
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP61287233
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 223822
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License Number State | LA
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Taxonomy #5
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | G168318
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License Number State | IA
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