Provider Demographics
NPI:1508122508
Name:KEISE, KAY (NP-C)
Entity Type:Individual
Prefix:MS
First Name:KAY
Middle Name:
Last Name:KEISE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3141 ROUTE 9W
Mailing Address - Street 2:STE 100
Mailing Address - City:NEW WINDSOR
Mailing Address - State:NY
Mailing Address - Zip Code:12553-6709
Mailing Address - Country:US
Mailing Address - Phone:845-565-9800
Mailing Address - Fax:
Practice Address - Street 1:3141 ROUTE 9W
Practice Address - Street 2:STE 100
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553-6709
Practice Address - Country:US
Practice Address - Phone:845-565-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-04
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF305566363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health