Provider Demographics
NPI:1538638242
Name:KEYS, MIESHA (BSN, RN)
Entity Type:Individual
Prefix:
First Name:MIESHA
Middle Name:
Last Name:KEYS
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 BUCKINGHAM RD APT 1434
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-5763
Mailing Address - Country:US
Mailing Address - Phone:469-684-2702
Mailing Address - Fax:
Practice Address - Street 1:430 BUCKINGHAM RD APT 1434
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-5763
Practice Address - Country:US
Practice Address - Phone:469-684-2702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-26
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX929257163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse