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General NPI Number Information
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NPI Number | 1942255245
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Entity Type | Individual
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Provider Name | KEITH ALLEN EVERITT APRN
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Gender | Male
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Dates
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Enumeration Date | 05/24/2006
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Last Update Date | 04/11/2024
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Provider Practice Location Address
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Address Line | 14 KNOX PLZ
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City | BARBOURVILLE
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State | KY
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Zip | 40906-7300
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Country | US
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Telephone | 606-546-7777
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Fax | 606-545-7611
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Provider Business Mailing Address
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Address Line | 325 FLOYD BRANCH RD
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City | BEREA
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State | KY
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Zip | 40403-8666
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Country | US
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Telephone | 859-986-6036
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Fax | 859-986-6036
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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 | 3002444
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License Number State | KY
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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 | 3002444
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License Number State | KY
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