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General NPI Number Information
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NPI Number | 1124367644
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Entity Type | Individual
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Provider Name | LAURA LYNN KEYS N.P.-C
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Gender | Female
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Dates
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Enumeration Date | 02/04/2013
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 1963 W MCDOWELL RD
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City | JACKSON
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State | MS
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Zip | 39204-4217
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Country | US
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Telephone | 601-372-3632
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Fax | 601-372-7361
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Provider Business Mailing Address
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Address Line | 1800 CLEARY RD
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City | FLORENCE
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State | MS
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Zip | 39073-8137
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Country | US
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Telephone | 601-624-5432
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R863885
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License Number State | MS
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