Provider Demographics
NPI:1750043436
Name:KEYES, TERRIANA MONET
Entity Type:Individual
Prefix:
First Name:TERRIANA
Middle Name:MONET
Last Name:KEYES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1474 TALLMADGE RD
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-6660
Mailing Address - Country:US
Mailing Address - Phone:234-817-3012
Mailing Address - Fax:
Practice Address - Street 1:1474 TALLMADGE RD
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-6660
Practice Address - Country:US
Practice Address - Phone:234-817-3012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-09
Last Update Date:2021-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health