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NPI Code Detail

MEDICARE: MRS. ALICE SUSAN KEETON CRNP

MEDICARE: MRS. ALICE SUSAN KEETON CRNP
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
1363LA2100XAcute Care Nurse Practitioner1052368AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1356312680
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ALICE SUSAN KEETON CRNP
Provider Business Mailing Address
First Line : 1100 SOUTH JACKSON HIGHWAY
Second Line : SUITE 150
City : SHEFFIELD
State : AL
Zip : 35660-5774
Country : US
Telephone Number : 256-383-4447
Fax Number : 256-381-7999
Provider Business Practice Location Address
First Line : 1100 SOUTH JACKSON HIGHWAY
Second Line : SUITE 150
City : SHEFFIELD
State : AL
Zip : 35660-5774
Country : US
Telephone Number : 256-383-4447
Fax Number : 256-381-7999
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2006
Last Update Date : 01/09/2012

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Directions to “ MRS. ALICE SUSAN KEETON CRNP” Practice Location

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