Provider Demographics
NPI:1316037740
Name:KEETON, CHRISTOPHER (APRN)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:KEETON
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1595
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41105-1595
Mailing Address - Country:US
Mailing Address - Phone:606-408-6200
Mailing Address - Fax:606-408-6612
Practice Address - Street 1:2001 SCIOTO TRL STE 300
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-5122
Practice Address - Country:US
Practice Address - Phone:740-353-6390
Practice Address - Fax:740-353-6290
Is Sole Proprietor?:No
Enumeration Date:2006-10-14
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3003305363LF0000X
OH06961-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY78007531Medicaid
OH2337715Medicaid
KY78007531Medicaid
KY3400317Medicare PIN
OHNP13455Medicare PIN
KY0264237Medicare PIN
KY0307633Medicare PIN
OHNP13452Medicare PIN
OHNP13453Medicare PIN
KY0632928Medicare PIN
OHNP13454Medicare PIN
OH2337715Medicaid
OHNP13451Medicare PIN