Provider Demographics
NPI:1972029031
Name:KEYS, MERRITT ELIZABETH (APRN)
Entity Type:Individual
Prefix:DR
First Name:MERRITT
Middle Name:ELIZABETH
Last Name:KEYS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1712 BRINK AVE
Mailing Address - Street 2:
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63703-6561
Mailing Address - Country:US
Mailing Address - Phone:573-450-7211
Mailing Address - Fax:
Practice Address - Street 1:1723 BROADWAY ST STE 310
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63701-4556
Practice Address - Country:US
Practice Address - Phone:573-331-7840
Practice Address - Fax:573-331-7849
Is Sole Proprietor?:No
Enumeration Date:2017-08-20
Last Update Date:2017-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011006429163W00000X
MO2017021981363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse