Provider Demographics
NPI:1679866990
Name:THE HEALTHKEY CLINIC, LLC
Entity Type:Organization
Organization Name:THE HEALTHKEY CLINIC, LLC
Other - Org Name:THE HEALTHKEY CLINIC, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNERE, FNP-BC
Authorized Official - Prefix:MRS
Authorized Official - First Name:GRETA
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:KEYS
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, MSN, FNP-BC
Authorized Official - Phone:601-833-3500
Mailing Address - Street 1:56 SPRING HILL RD
Mailing Address - Street 2:
Mailing Address - City:SILVER CREEK
Mailing Address - State:MS
Mailing Address - Zip Code:39663-5201
Mailing Address - Country:US
Mailing Address - Phone:601-455-4230
Mailing Address - Fax:601-292-6384
Practice Address - Street 1:55 SPRING HILL RD
Practice Address - Street 2:
Practice Address - City:SILVER CREEK
Practice Address - State:MS
Practice Address - Zip Code:39663-5200
Practice Address - Country:US
Practice Address - Phone:601-833-3500
Practice Address - Fax:601-292-6384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-19
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS004250219Medicaid
MS302G500382Medicare PIN