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NPI Code Detail

MEDICARE: MCKENNA RAE KEYES

MEDICARE: MCKENNA RAE KEYES
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
1152W00000XOptometrist4901005950MI

General Provider Information

NPI Number : 1366390031
Entity Type Code : Individual
Provider Name (Legal Business Name) : MCKENNA RAE KEYES
Provider Business Mailing Address
First Line : 750 E BELTLINE AVE NE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49525-6049
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 537 W MAIN ST
Second Line :
City : IONIA
State : MI
Zip : 48846-1652
Country : US
Telephone Number : 616-588-6598
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2026
Last Update Date : 06/10/2026

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Directions to “ MCKENNA RAE KEYES ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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