Provider Demographics
NPI:1659972479
Name:ALLMARAS, KEATON (APRN)
Entity Type:Individual
Prefix:
First Name:KEATON
Middle Name:
Last Name:ALLMARAS
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4998 CROSSINGS CIR STE 200
Mailing Address - Street 2:
Mailing Address - City:MT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-0018
Mailing Address - Country:US
Mailing Address - Phone:615-553-5000
Mailing Address - Fax:833-441-2292
Practice Address - Street 1:4998 CROSSING CIRCLE
Practice Address - Street 2:SUITE 200
Practice Address - City:MT. JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122
Practice Address - Country:US
Practice Address - Phone:615-553-5000
Practice Address - Fax:615-758-3875
Is Sole Proprietor?:No
Enumeration Date:2020-11-06
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN28260363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care