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General NPI Number Information
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NPI Number | 1376046177
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Entity Type | Individual
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Provider Name | CAITLIN KECKEIS APRN
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Gender | Female
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Dates
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Enumeration Date | 03/18/2018
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Last Update Date | 11/19/2021
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Provider Practice Location Address
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Address Line | 7777 YANKEE RD # MLC16078
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City | LIBERTY TOWNSHIP
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State | OH
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Zip | 45044-3500
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Country | US
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Telephone | 513-636-8790
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Fax | 513-803-8406
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Provider Business Mailing Address
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Address Line | 7777 YANKEE RD # MLC16078
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City | LIBERTY TOWNSHIP
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State | OH
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Zip | 45044-3500
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Country | US
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Telephone | 513-636-8790
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Fax | 513-803-8406
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN.CNP.022263
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN.385891
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License Number State | OH
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