Provider Demographics
NPI:1407399793
Name:KEETON, MEGAN (CNIM)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:KEETON
Suffix:
Gender:F
Credentials:CNIM
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:BARNES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:446 DWARF GRASS CT
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30045-8185
Mailing Address - Country:US
Mailing Address - Phone:770-634-6580
Mailing Address - Fax:866-213-6363
Practice Address - Street 1:446 DWARF GRASS CT
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30045-8185
Practice Address - Country:US
Practice Address - Phone:770-634-6580
Practice Address - Fax:866-213-6363
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-18
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic