Provider Demographics
NPI:1649038159
Name:KEYES, DENNIS M (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:M
Last Name:KEYES
Suffix:
Gender:
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 W 4800 S STE 101
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-3781
Mailing Address - Country:US
Mailing Address - Phone:385-315-8302
Mailing Address - Fax:771-202-9128
Practice Address - Street 1:84 W 4800 S STE 101
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-3781
Practice Address - Country:US
Practice Address - Phone:801-224-8800
Practice Address - Fax:801-262-0998
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-08
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7353740-4405363LF0000X, 363LP2300X, 251G00000X, 363LG0600X
UT7353740-3102163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No251G00000XAgenciesHospice Care, Community Based
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology