Provider Demographics
NPI:1639845001
Name:KEITH, ALISON L (ARNP)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:L
Last Name:KEITH
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2920 ALT 19 # 39
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-1501
Mailing Address - Country:US
Mailing Address - Phone:512-767-4917
Mailing Address - Fax:
Practice Address - Street 1:5537 GULF DR
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-4021
Practice Address - Country:US
Practice Address - Phone:727-849-2600
Practice Address - Fax:727-845-1803
Is Sole Proprietor?:No
Enumeration Date:2021-08-17
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11017194363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily