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NPI Code Detail

MEDICARE: MS. SUSAN KAY KEIZER MSED, RD, LMNT, CDE

MEDICARE: MS. SUSAN KAY KEIZER MSED, RD, LMNT, CDE
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
1133V00000XRegistered Dietitian430NE

General Provider Information

NPI Number : 1063578839
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SUSAN KAY KEIZER MSED, RD, LMNT, CDE
Provider Business Mailing Address
First Line : 4211 LINDEN DR
Second Line :
City : KEARNEY
State : NE
Zip : 68847-2507
Country : US
Telephone Number : 308-240-0056
Fax Number :
Provider Business Practice Location Address
First Line : 3219 CENTRAL AVE
Second Line : PLATTE VALLEY MEDICAL GROUP
City : KEARNEY
State : NE
Zip : 68847-2949
Country : US
Telephone Number : 308-865-2263
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2006
Last Update Date : 10/21/2009

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