MEDICARE: LISA KEELEY LVN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164X00000X	Licensed Vocational Nurse	705611	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	LISAKEELEY	OTHER	CA	ALL OTHER INSURANCE

General Provider Information

NPI Number	:	1013530005
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA KEELEY LVN

Provider Business Mailing Address
First Line	:	4760 SWEENEY CIR
Second Line	:
City	:	ROCKLIN
State	:	CA
Zip	:	95677-2885
Country	:	US
Telephone Number	:	530-305-3384
Fax Number	:

Provider Business Practice Location Address
First Line	:	8946 MADISON AVE
Second Line	:
City	:	FAIR OAKS
State	:	CA
Zip	:	95628-4010
Country	:	US
Telephone Number	:	530-305-3384
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/25/2020
Last Update Date	:	05/25/2020

Similar Medicare Providers

1982883831 — CSTL, INC.
Practice Location Address:

8938 MADISON AVE
FAIR OAKS, CA
95628-4010

Practice Phone: 916-961-2691
Practice Fax:

1629235643 — KIM AND RODGERS DENTAL CORPORATION
Practice Location Address:

8908 MADISON AVE , SUITE A
FAIR OAKS, CA
95628-4010

Practice Phone: 951-536-5151
Practice Fax: 916-536-5154

1184874695 — DR. EMMANUEL I OSORIO DDS
Practice Location Address:

8908 MADISON AVE , STE C
FAIR OAKS, CA
95628-4010

Practice Phone: 916-536-5151
Practice Fax: 916-536-5154

1023631025 — STUART J PERKINS
Practice Location Address:

8946 MADISON AVE
FAIR OAKS, CA
95628-4010

Practice Phone: 916-599-0673
Practice Fax:

1790308799 — LISA IWANYCZKO LVN
Practice Location Address:

8946 MADISON AVE
FAIR OAKS, CA
95628-4010

Practice Phone: 916-438-9569
Practice Fax:

1144843889 — BETHANY BRYANT
Practice Location Address:

8946 MADISON AVE
FAIR OAKS, CA
95628-4010

Practice Phone: 916-438-9569
Practice Fax:

Directions to “ LISA KEELEY LVN” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.