Provider Demographics
NPI:1922556984
Name:KEIDEL, ELIZABETH (RN, BSN, LSN)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:
Last Name:KEIDEL
Suffix:
Gender:F
Credentials:RN, BSN, LSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4924 BRITTON FARMS CT
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-8201
Mailing Address - Country:US
Mailing Address - Phone:614-353-9801
Mailing Address - Fax:
Practice Address - Street 1:4924 BRITTON FARMS CT
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-8201
Practice Address - Country:US
Practice Address - Phone:614-353-9801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-19
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH312529163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse