Provider Demographics
NPI:1972675031
Name:KEATON, PATRICIA ELLEN
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:ELLEN
Last Name:KEATON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31317 N BLACKFOOT DR
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85243
Mailing Address - Country:US
Mailing Address - Phone:480-726-2166
Mailing Address - Fax:
Practice Address - Street 1:31317 N BLACKFOOT DR
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85243
Practice Address - Country:US
Practice Address - Phone:480-726-2166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant