Provider Demographics
NPI:1952632598
Name:KEYL, NASREEN DONNA (PA-C)
Entity Type:Individual
Prefix:MS
First Name:NASREEN
Middle Name:DONNA
Last Name:KEYL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2145 E BASELINE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-1546
Mailing Address - Country:US
Mailing Address - Phone:480-776-1600
Mailing Address - Fax:480-776-0025
Practice Address - Street 1:1570 E TUCSON MARKETPLACE BLVD STE 140
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85713-6570
Practice Address - Country:US
Practice Address - Phone:520-301-2300
Practice Address - Fax:520-301-2303
Is Sole Proprietor?:No
Enumeration Date:2010-01-21
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AKPADA1180363A00000X
AZ8062363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8943564Medicare UPIN