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NPI Code Detail

MEDICARE: CLAYTON KEYE PMHNP

MEDICARE:   CLAYTON  KEYE  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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner2024064015GA

General Provider Information

NPI Number : 1053121046
Entity Type Code : Individual
Provider Name (Legal Business Name) : CLAYTON KEYE PMHNP
Provider Business Mailing Address
First Line : 4995 FIELDSTONE VIEW CIR
Second Line :
City : CUMMING
State : GA
Zip : 30028-3868
Country : US
Telephone Number : 912-257-9076
Fax Number :
Provider Business Practice Location Address
First Line : 8025 MAJORS RD
Second Line :
City : CUMMING
State : GA
Zip : 30041-7056
Country : US
Telephone Number : 770-670-5926
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2025
Last Update Date : 01/10/2025

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