Provider Demographics
NPI:1679689574
Name:KEILMAN, LINDA J (NP)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:J
Last Name:KEILMAN
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:804 SERVICE RD
Mailing Address - Street 2:STE A109B
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48824-7015
Mailing Address - Country:US
Mailing Address - Phone:517-353-8122
Mailing Address - Fax:517-432-3713
Practice Address - Street 1:804 SERVICE RD STE A217
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48824-7015
Practice Address - Country:US
Practice Address - Phone:517-353-8122
Practice Address - Fax:517-432-3713
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2021-06-09
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Provider Licenses
StateLicense IDTaxonomies
MI4704143007363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4601223Medicaid
MI4601223Medicaid