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NPI Code Detail

MEDICARE: JANICE EVELYN KEITZ NP

MEDICARE: JANICE EVELYN KEITZ NP
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
1163W00000XRegistered Nurse0001051220VA
2363L00000XNurse Practitioner0024051220VA

General Provider Information

NPI Number : 1790897809
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANICE EVELYN KEITZ NP
Provider Business Mailing Address
First Line : 9 GREENWAY PLZ
Second Line : SUITE 2950
City : HOUSTON
State : TX
Zip : 77046-0905
Country : US
Telephone Number : 866-607-7334
Fax Number : 713-358-4801
Provider Business Practice Location Address
First Line : 12000 IRON BRIDGE RD
Second Line :
City : CHESTER
State : VA
Zip : 23831-1459
Country : US
Telephone Number : 804-748-7117
Fax Number : 804-748-6166
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 09/10/2008

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