Provider Demographics
NPI:1205254588
Name:CLOUD, KEESHIA (CRNP)
Entity type:Individual
Prefix:
First Name:KEESHIA
Middle Name:
Last Name:CLOUD
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6727 HIGHWAY 431 S STE L
Mailing Address - Street 2:
Mailing Address - City:OWENS CROSS ROADS
Mailing Address - State:AL
Mailing Address - Zip Code:35763-9226
Mailing Address - Country:US
Mailing Address - Phone:256-489-2870
Mailing Address - Fax:
Practice Address - Street 1:6727 HIGHWAY 431 S STE L
Practice Address - Street 2:
Practice Address - City:OWENS CROSS ROADS
Practice Address - State:AL
Practice Address - Zip Code:35763-9226
Practice Address - Country:US
Practice Address - Phone:256-489-2870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-02
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-135656363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily