Provider Demographics
NPI:1356592976
Name:KEIL, MINDY (PA-C)
Entity type:Individual
Prefix:
First Name:MINDY
Middle Name:
Last Name:KEIL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MINDY
Other - Middle Name:
Other - Last Name:GILBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1308 W FOURTH ST
Mailing Address - Street 2:
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82716-3330
Mailing Address - Country:US
Mailing Address - Phone:307-687-1300
Mailing Address - Fax:307-682-1309
Practice Address - Street 1:1308 W 4TH ST
Practice Address - Street 2:
Practice Address - City:GILLETTE
Practice Address - State:WY
Practice Address - Zip Code:82716-3330
Practice Address - Country:US
Practice Address - Phone:307-687-1300
Practice Address - Fax:307-682-1309
Is Sole Proprietor?:No
Enumeration Date:2008-10-01
Last Update Date:2017-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical