Provider Demographics
NPI:1619925286
Name:KEELS, LAURA MARIE (FNP)
Entity Type:Individual
Prefix:MISS
First Name:LAURA
Middle Name:MARIE
Last Name:KEELS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:NA
Other - Middle Name:NA
Other - Last Name:NA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN, FNP
Mailing Address - Street 1:215 PACIFICA AVE
Mailing Address - Street 2:
Mailing Address - City:BAY POINT
Mailing Address - State:CA
Mailing Address - Zip Code:94565-2904
Mailing Address - Country:US
Mailing Address - Phone:925-427-8300
Mailing Address - Fax:925-427-8304
Practice Address - Street 1:2500 ALHAMBRA AVE
Practice Address - Street 2:NA
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-3156
Practice Address - Country:US
Practice Address - Phone:925-370-5200
Practice Address - Fax:925-427-8304
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15848363LF0000X, 363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology