Provider Demographics
NPI:1457110603
Name:KEYES, IRIS D
Entity Type:Individual
Prefix:
First Name:IRIS
Middle Name:D
Last Name:KEYES
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 1:4372 THELMA DR
Mailing Address - Street 2:
Mailing Address - City:OBETZ
Mailing Address - State:OH
Mailing Address - Zip Code:43207-5248
Mailing Address - Country:US
Mailing Address - Phone:614-772-3984
Mailing Address - Fax:
Practice Address - Street 1:4372 THELMA DR
Practice Address - Street 2:
Practice Address - City:OBETZ
Practice Address - State:OH
Practice Address - Zip Code:43207-5248
Practice Address - Country:US
Practice Address - Phone:614-772-3984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide