Provider Demographics
NPI:1144840786
Name:KEELER, NICHOLAS FISKE (AG-ACNP, DNP, RN)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:FISKE
Last Name:KEELER
Suffix:
Gender:M
Credentials:AG-ACNP, DNP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 PARNASSUS AVE STE 5015TH
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-2202
Mailing Address - Country:US
Mailing Address - Phone:415-353-9088
Mailing Address - Fax:415-353-3889
Practice Address - Street 1:400 PARNASSUS AVE STE 5015TH
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-2202
Practice Address - Country:US
Practice Address - Phone:415-353-9088
Practice Address - Fax:415-353-3889
Is Sole Proprietor?:No
Enumeration Date:2020-04-23
Last Update Date:2023-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95013484363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care