Provider Demographics
NPI:1639510142
Name:KEYS, JOSEPH CHANCE (NP)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:CHANCE
Last Name:KEYS
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 BLUE HERON BLVD
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564-9718
Mailing Address - Country:US
Mailing Address - Phone:601-394-7977
Mailing Address - Fax:
Practice Address - Street 1:2101 HIGHWAY 90
Practice Address - Street 2:
Practice Address - City:GAUTIER
Practice Address - State:MS
Practice Address - Zip Code:39553-5340
Practice Address - Country:US
Practice Address - Phone:228-497-8874
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-12
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR872976363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily