Provider Demographics
NPI:1770708414
Name:KEELER, ANNE WEST (RD)
Entity type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:WEST
Last Name:KEELER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:MISS
Other - First Name:ANNE
Other - Middle Name:ELIZABETH
Other - Last Name:WEST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:PO BOX 758997
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21275-0001
Mailing Address - Country:US
Mailing Address - Phone:804-828-2841
Mailing Address - Fax:804-628-0783
Practice Address - Street 1:1250 E MARSHALL STREET
Practice Address - Street 2:CLINICAL NUTRITION
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-0294
Practice Address - Country:US
Practice Address - Phone:804-828-0970
Practice Address - Fax:804-628-0921
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAP62233Medicare UPIN
VA710000038Medicare ID - Type UnspecifiedC06293