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General NPI Number Information
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NPI Number | 1700906088
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Entity Type | Individual
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Provider Name | ERIN JEAN KEECH PA-C
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Gender | Female
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 10/31/2018
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Provider Practice Location Address
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Address Line | 1457 WHITE OAK DR
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City | CHASKA
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State | MN
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Zip | 55318-2525
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Country | US
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Telephone | 952-368-3800
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Fax |
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Provider Business Mailing Address
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Address Line | 800 BIESTERFIELD RD SUITE # 106
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City | ELK GROVE VILLAGE
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State | IL
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Zip | 60007-3372
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Country | US
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Telephone | 847-981-8866
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Fax | 847-981-5580
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 085.002860
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 12422
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License Number State | MN
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