Provider Demographics
NPI:1871094805
Name:KEELING, LINDA JO
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:JO
Last Name:KEELING
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 1:171 WOLFF DR
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75092-6355
Mailing Address - Country:US
Mailing Address - Phone:903-375-2126
Mailing Address - Fax:
Practice Address - Street 1:171 WOLFF DR
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092-6355
Practice Address - Country:US
Practice Address - Phone:903-375-2126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-25
Last Update Date:2018-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant