Provider Demographics
NPI:1235644006
Name:LLOYD, KEESHA DAWN (FNP-BC)
Entity Type:Individual
Prefix:
First Name:KEESHA
Middle Name:DAWN
Last Name:LLOYD
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12625 HERNDON RD
Mailing Address - Street 2:
Mailing Address - City:SPOTSYLVANIA
Mailing Address - State:VA
Mailing Address - Zip Code:22553-4036
Mailing Address - Country:US
Mailing Address - Phone:724-851-1500
Mailing Address - Fax:
Practice Address - Street 1:11131 JOURNAL PKWY
Practice Address - Street 2:
Practice Address - City:KING GEORGE
Practice Address - State:VA
Practice Address - Zip Code:22485-3468
Practice Address - Country:US
Practice Address - Phone:540-625-2527
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-02
Last Update Date:2017-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024174811363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily