Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 1030124 | TX |
NPI | 1144814211 |
---|---|
Provider Name | Ms. Anne Marie Keithly |
First Address | Houston, TX 77030 |
Second Address | Houston, TX 77030-1501 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/03/2021 |
Last Update Date | 01/03/2021 |