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NPI Code Detail

MEDICARE: JOYCE KEATON

MEDICARE:   JOYCE  KEATON
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
13747P1801XPersonal Care Attendant

Other Identifiers

General Provider Information

NPI Number : 1316542426
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOYCE KEATON
Provider Business Mailing Address
First Line : 1710 PENNSYLVANIA AVE
Second Line :
City : CHARLESTON
State : WV
Zip : 25302-3934
Country : US
Telephone Number : 304-348-0707
Fax Number : 304-344-3546
Provider Business Practice Location Address
First Line : 1710 PENNSYLVANIA AVE
Second Line :
City : CHARLESTON
State : WV
Zip : 25302-3934
Country : US
Telephone Number : 304-348-0707
Fax Number : 304-344-3546
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2020
Last Update Date : 12/04/2020

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