Provider Demographics
NPI:1912425380
Name:KEISER, KIM LEE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:KIM
Middle Name:LEE
Last Name:KEISER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7126 E PARK CT NE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-7470
Mailing Address - Country:US
Mailing Address - Phone:319-423-5113
Mailing Address - Fax:
Practice Address - Street 1:3701 KATZ DR
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IA
Practice Address - Zip Code:52302-3871
Practice Address - Country:US
Practice Address - Phone:319-373-3022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-06
Last Update Date:2017-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA129916363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily