Provider Demographics
NPI:1629014154
Name:KEEBLER, NANCY C
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:C
Last Name:KEEBLER
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 1:38 LEDGELAWN AVE
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02420-3435
Mailing Address - Country:US
Mailing Address - Phone:978-462-4500
Mailing Address - Fax:
Practice Address - Street 1:19 CENTRAL ST
Practice Address - Street 2:
Practice Address - City:BYFIELD
Practice Address - State:MA
Practice Address - Zip Code:01922-1233
Practice Address - Country:US
Practice Address - Phone:978-462-4500
Practice Address - Fax:978-462-1275
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7898225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist