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MS. DIANNA LAVEE KEELING FNP

Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1609115237

Individual Registrant:
MS. DIANNA LAVEE KEELING FNP
Gender: F
Not Sole Proprietor

Location and contact information for practice:
233 S MAIN ST  LICKING, MO 65542-9325 US
Tel: 573-674-3011  Fax: 573-674-4765

Contact information for business:
PO BOX 47  LICKING, MO 65542-0047 US
Tel: 573-674-3011  Fax: 573-674-4765

Registration Information:
NPI: 1609115237
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Family
MO2013002123

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
RR MCRP01235241MO01
1609115237MO05
420002899MO05
CLIA26D0679044MO01
TRICARE431560263MO01




HEALTH CARE JOBS MO - Page 1



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