MEDICARE: ASHONTIS KEYS FNP, PMHNP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	221953	LA
2	363LF0000X	Family Nurse Practitioner	221953	LA

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

General Provider Information

NPI Number	:	1023787132
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHONTIS KEYS FNP, PMHNP

Provider Business Mailing Address
First Line	:	8923 BLUEBONNET BLVD
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70810-2814
Country	:	US
Telephone Number	:	225-766-4133
Fax Number	:	225-766-4135

Provider Business Practice Location Address
First Line	:	8923 BLUEBONNET BLVD
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70810-2814
Country	:	US
Telephone Number	:	225-766-4133
Fax Number	:

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

Provider Enumeration Date	:	09/10/2021
Last Update Date	:	01/27/2026

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