Provider Demographics
NPI:1437783354
Name:KEYES, AUDRAMURAH ANTOINETTE
Entity Type:Individual
Prefix:
First Name:AUDRAMURAH
Middle Name:ANTOINETTE
Last Name:KEYES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:591 BRITTAIN RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44305-2034
Mailing Address - Country:US
Mailing Address - Phone:330-861-4246
Mailing Address - Fax:
Practice Address - Street 1:591 BRITTAIN RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44305-2034
Practice Address - Country:US
Practice Address - Phone:330-861-4246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-29
Last Update Date:2020-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty