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General NPI Number Information
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NPI Number | 1669133427
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Entity Type | Individual
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Provider Name | BOBBI KEYSER DNP
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Gender | Female
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Dates
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Enumeration Date | 01/04/2022
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Last Update Date | 08/29/2024
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Provider Practice Location Address
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Address Line | 2841 AVENUE G STE 100
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City | WHITE CITY
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State | OR
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Zip | 97503-3030
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Country | US
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Telephone | 541-826-5252
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Fax |
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Provider Business Mailing Address
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Address Line | 2825 E BARNETT RD # MSS
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City | MEDFORD
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State | OR
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Zip | 97504-8332
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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 | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 202008767RN
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 10031226
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License Number State | OR
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