MEDICARE: MISS JENNA NICOLE KEYS MA

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
1	101YM0800X	Mental Health Counselor	0704015076	VA

General Provider Information

NPI Number	:	1467272369
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS JENNA NICOLE KEYS MA

Provider Business Mailing Address
First Line	:	116 LIPTON LN
Second Line	:
City	:	DANVILLE
State	:	VA
Zip	:	24541-4618
Country	:	US
Telephone Number	:	571-358-0129
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 PINEY FOREST RD
Second Line	:
City	:	DANVILLE
State	:	VA
Zip	:	24540-3315
Country	:	US
Telephone Number	:	434-272-8372
Fax Number	:	434-381-4316

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/15/2024
Last Update Date	:	04/22/2026

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