Provider Demographics
NPI:1285185637
Name:KEATS, AMINAH (ND)
Entity Type:Individual
Prefix:DR
First Name:AMINAH
Middle Name:
Last Name:KEATS
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4701 SANGAMORE RD
Mailing Address - Street 2:STE N270
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20816-2508
Mailing Address - Country:US
Mailing Address - Phone:847-644-9799
Mailing Address - Fax:
Practice Address - Street 1:4701 SANGAMORE RD
Practice Address - Street 2:STE N270
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20816-2508
Practice Address - Country:US
Practice Address - Phone:847-644-9799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-20
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDJ0000018133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education