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NPI Code Detail

MEDICARE: MR. JOHN ROBERT KECK N.P.

MEDICARE: MR. JOHN ROBERT KECK N.P.
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 PractitionerAP2289AZ

General Provider Information

NPI Number : 1215047766
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOHN ROBERT KECK N.P.
Provider Business Mailing Address
First Line : 11047 N 19TH AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85029-4816
Country : US
Telephone Number : 602-589-0500
Fax Number : 602-314-4552
Provider Business Practice Location Address
First Line : 11047 N 19TH AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85029-4816
Country : US
Telephone Number : 602-589-0500
Fax Number : 602-314-4552
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2006
Last Update Date : 12/04/2025

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Directions to “ MR. JOHN ROBERT KECK N.P.” Practice Location

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