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NPI Code Detail

MEDICARE: KEIANA CORPREW FNP

MEDICARE: KEIANA CORPREW FNP
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
1363LF0000XFamily Nurse PractitionerF12250605NC

General Provider Information

NPI Number : 1851250948
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEIANA CORPREW FNP
Provider Business Mailing Address
First Line : 1140 BLACK JACK SIMPSON RD
Second Line :
City : GREENVILLE
State : NC
Zip : 27858-7728
Country : US
Telephone Number : 703-593-6279
Fax Number :
Provider Business Practice Location Address
First Line : 250 LOVERS LN
Second Line :
City : WASHINGTON
State : NC
Zip : 27889-3436
Country : US
Telephone Number : 252-975-1636
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/15/2026
Last Update Date : 01/15/2026

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