Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 4873 | MN |
N | 363L00000X | Nurse Practitioner | CNP 4873 | MN |
N | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 2015034703 | MO |
NPI | 1013387950 |
---|---|
Provider Name | Dr. Nicola Keeth |
First Address | Rochester, MN 55905-0001 |
Second Address | Rochester, MN 55905-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2015 |
Last Update Date | 07/08/2020 |