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NPI Code Detail

MEDICARE: MS. REBECCA MARTIN KEATON ARNP/CNM

MEDICARE: MS. REBECCA MARTIN KEATON ARNP/CNM
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
1367A00000XAdvanced Practice Midwife587042FL

General Provider Information

NPI Number : 1508979212
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. REBECCA MARTIN KEATON ARNP/CNM
Provider Business Mailing Address
First Line : 1321 BONNIE DR
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32304-1213
Country : US
Telephone Number : 850-575-1700
Fax Number :
Provider Business Practice Location Address
First Line : 278 LASALLE LAFALL DR
Second Line :
City : QUINCY
State : FL
Zip : 32351-5324
Country : US
Telephone Number : 850-875-7200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2006
Last Update Date : 07/08/2007

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