Provider Demographics
NPI:1972286359
Name:KEYS, LAURIEL (MIDWIFE)
Entity Type:Individual
Prefix:
First Name:LAURIEL
Middle Name:
Last Name:KEYS
Suffix:
Gender:F
Credentials:MIDWIFE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 CANDLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ENFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06082-2740
Mailing Address - Country:US
Mailing Address - Phone:860-985-4891
Mailing Address - Fax:
Practice Address - Street 1:102 CANDLEWOOD DR
Practice Address - Street 2:
Practice Address - City:ENFIELD
Practice Address - State:CT
Practice Address - Zip Code:06082-2740
Practice Address - Country:US
Practice Address - Phone:860-985-4891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay