Keith, Laura N

Keith, Laura N is an individual health care provider with primary practice located at 421 S 28Th Ave , Hattiesburg MS 39401-7236. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Keith, Laura N can be contacted via phone (601) 268-5640.

Contact Information

Primary practice address
421 S 28Th Ave Hattiesburg MS 39401-7236
Phone: (601) 268-5640
Fax: (601) 261-3507
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X RS14087 Mississippi

Profile Details

NPI number 1073539409
LBN Legal business name Keith, Laura N
Credentials Certified Nurse Practitioner (CNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 15th, 2006
Last updated Aug 23rd, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073539409 NPPES
Mississippi Other 3513360 AMERICAN ADMIN GROUP
Mississippi MEDICAID 00125348 AMERICAN ADMIN GROUP
Mississippi MEDICAID 1582280 AMERICAN ADMIN GROUP

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