Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 4301074290 | MI |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 4301074290 | MI |
NPI | 1295855070 |
---|---|
Provider Name | Dr. Kristie Lynn Keeton |
First Address | Ann Arbor, MI 48105-9484 |
Second Address | Ypsilanti, MI 48197-1142 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2007 |
Last Update Date | 05/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H89687 | (02) | MI |