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General NPI Number Information
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NPI Number | 1124008461
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Entity Type | Individual
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Provider Name | VICTORIA LYNN KEYTON ANP-C
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Gender | Female
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Dates
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Enumeration Date | 01/20/2006
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 4830 CENTRAL PARK DR
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City | OKEMOS
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State | MI
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Zip | 48864-2089
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Country | US
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Telephone | 517-743-0879
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 22062
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City | LANSING
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State | MI
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Zip | 48909-2062
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Country | US
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Telephone |
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Fax |
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 200550100NP
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 200550100NP
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License Number State | OR
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