Provider Demographics
NPI:1700040771
Name:KEESLAR, IREENA K (CPM)
Entity Type:Individual
Prefix:
First Name:IREENA
Middle Name:K
Last Name:KEESLAR
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7570 E 750 N
Mailing Address - Street 2:
Mailing Address - City:HOWE
Mailing Address - State:IN
Mailing Address - Zip Code:46746-9224
Mailing Address - Country:US
Mailing Address - Phone:260-367-1544
Mailing Address - Fax:
Practice Address - Street 1:7570 E 750 N
Practice Address - Street 2:
Practice Address - City:HOWE
Practice Address - State:IN
Practice Address - Zip Code:46746-9224
Practice Address - Country:US
Practice Address - Phone:260-367-1544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-17
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No175M00000XOther Service ProvidersMidwife, Lay