Provider Demographics
NPI:1710911037
Name:KEATING, NORA E (MD)
Entity Type:Individual
Prefix:DR
First Name:NORA
Middle Name:E
Last Name:KEATING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 4TH AVE E
Mailing Address - Street 2:PO BOX 210
Mailing Address - City:TRENTON
Mailing Address - State:ND
Mailing Address - Zip Code:58853-0210
Mailing Address - Country:US
Mailing Address - Phone:701-774-0461
Mailing Address - Fax:701-774-8003
Practice Address - Street 1:331 4TH AVE E
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:ND
Practice Address - Zip Code:58853-0210
Practice Address - Country:US
Practice Address - Phone:701-774-0461
Practice Address - Fax:701-774-8003
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND6414207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND11806OtherBLUE CROSS OF ND
ND17333Medicaid
NDN11806Medicare ID - Type Unspecified
ND17333Medicaid