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General NPI Number Information
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NPI Number | 1376686253
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Entity Type | Individual
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Provider Name | TINA E. KEELER
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Gender | Female
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 06/24/2021
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Provider Practice Location Address
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Address Line | 1400 E. BOULDER STREET
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-5533
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Country | US
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Telephone | 719-365-6820
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Fax | 303-306-7753
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Provider Business Mailing Address
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Address Line | P.O. BOX 173891
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City | DENVER
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State | CO
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Zip | 80217-9294
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Country | US
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Telephone | 303-306-7783
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Fax | 303-306-7753
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | APN.0005064-NP
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | APN.0005064-NP
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5064
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License Number State | CO
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APN.0005064-NP
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License Number State | CO
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