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NPI Code Detail

MEDICARE: PATRICK G KEEBEY RN, MBA

MEDICARE:   PATRICK G KEEBEY  RN, MBA
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
1163WG0000XGeneral Practice Registered Nurse135651MO

General Provider Information

NPI Number : 1649804758
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICK G KEEBEY RN, MBA
Provider Business Mailing Address
First Line : 1974 LAKE FOREST CIR
Second Line :
City : PAGOSA SPRINGS
State : CO
Zip : 81147-9392
Country : US
Telephone Number : 573-308-2708
Fax Number :
Provider Business Practice Location Address
First Line : 1974 LAKE FOREST CIR
Second Line :
City : PAGOSA SPRINGS
State : CO
Zip : 81147-9392
Country : US
Telephone Number : 573-308-2708
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2020
Last Update Date : 02/27/2020

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