Provider Demographics
NPI:1225500283
Name:BONE, KEAW'E K
Entity Type:Individual
Prefix:
First Name:KEAW'E
Middle Name:K
Last Name:BONE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 WILDROSE TRACE DR
Mailing Address - Street 2:
Mailing Address - City:CHEROKEE
Mailing Address - State:NC
Mailing Address - Zip Code:28719-4532
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2670 CORNSILK BRANCH RD.
Practice Address - Street 2:
Practice Address - City:SNOWBIRD
Practice Address - State:NC
Practice Address - Zip Code:28771
Practice Address - Country:US
Practice Address - Phone:828-346-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-31
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty