Provider Demographics
NPI:1922653690
Name:KESHAVJIVAN PLLC
Entity Type:Organization
Organization Name:KESHAVJIVAN PLLC
Other - Org Name:SONORAN FAMILY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:CHETAN
Authorized Official - Middle Name:SHAILESHKUMAR
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:520-723-7726
Mailing Address - Street 1:171 W CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:COOLIDGE
Mailing Address - State:AZ
Mailing Address - Zip Code:85128-4405
Mailing Address - Country:US
Mailing Address - Phone:520-723-7726
Mailing Address - Fax:520-723-4513
Practice Address - Street 1:171 W CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:COOLIDGE
Practice Address - State:AZ
Practice Address - Zip Code:85128-4405
Practice Address - Country:US
Practice Address - Phone:520-723-7726
Practice Address - Fax:520-723-4513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-08
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty