Provider Demographics
NPI:1396393138
Name:KEYS, DANA LYNN (PA-C)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:LYNN
Last Name:KEYS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 DIAMANTE DR
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27527-9318
Mailing Address - Country:US
Mailing Address - Phone:703-517-9323
Mailing Address - Fax:
Practice Address - Street 1:115 KILDAIRE PARK DR STE 402
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-8130
Practice Address - Country:US
Practice Address - Phone:919-443-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-26
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-09384363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant