Provider Demographics
NPI:1447062740
Name:CEPHUS, KEISHA LADEY
Entity type:Individual
Prefix:
First Name:KEISHA
Middle Name:LADEY
Last Name:CEPHUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5757 WOOLDRIDGE RD APT 29E
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-3832
Mailing Address - Country:US
Mailing Address - Phone:806-559-0559
Mailing Address - Fax:
Practice Address - Street 1:5757 WOOLDRIDGE RD APT 29E
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-3832
Practice Address - Country:US
Practice Address - Phone:806-559-0559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX990032163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse