Provider Demographics
NPI:1255180246
Name:KEE ESSENTIALS
Entity type:Organization
Organization Name:KEE ESSENTIALS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:KEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-885-0881
Mailing Address - Street 1:7618 N DECATUR BLVD APT 1063
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89131-3620
Mailing Address - Country:US
Mailing Address - Phone:702-885-0881
Mailing Address - Fax:
Practice Address - Street 1:6260 MCLEOD DR STE 120
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-4445
Practice Address - Country:US
Practice Address - Phone:702-885-0881
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-14
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty