Provider Demographics
NPI:1871702399
Name:KEITH, JANEE
Entity type:Individual
Prefix:MS
First Name:JANEE
Middle Name:
Last Name:KEITH
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 1:2704 21ST AVE
Mailing Address - Street 2:
Mailing Address - City:PHENIX CITY
Mailing Address - State:AL
Mailing Address - Zip Code:36867-3002
Mailing Address - Country:US
Mailing Address - Phone:334-298-5395
Mailing Address - Fax:334-298-5395
Practice Address - Street 1:2704 21ST AVE
Practice Address - Street 2:
Practice Address - City:PHENIX CITY
Practice Address - State:AL
Practice Address - Zip Code:36867-3002
Practice Address - Country:US
Practice Address - Phone:334-298-5395
Practice Address - Fax:334-298-5395
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor