MEDICARE: ALISON L KEITH ARNP

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	363LF0000X	Family Nurse Practitioner	APRN11017194	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1639845001
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALISON L KEITH ARNP

Provider Business Mailing Address
First Line	:	2920 ALT 19 # 39
Second Line	:
City	:	DUNEDIN
State	:	FL
Zip	:	34698-1501
Country	:	US
Telephone Number	:	512-767-4917
Fax Number	:

Provider Business Practice Location Address
First Line	:	5537 GULF DR
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34652-4021
Country	:	US
Telephone Number	:	727-849-2600
Fax Number	:	727-845-1803

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

Provider Enumeration Date	:	08/17/2021
Last Update Date	:	01/06/2023

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