Provider Demographics
NPI:1982918520
Name:KEIPE, PATRICE L (HYGIENIST)
Entity Type:Individual
Prefix:
First Name:PATRICE
Middle Name:L
Last Name:KEIPE
Suffix:
Gender:F
Credentials:HYGIENIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5380 BEAVER DAM DR SW
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:MN
Mailing Address - Zip Code:56308-6054
Mailing Address - Country:US
Mailing Address - Phone:320-886-5538
Mailing Address - Fax:
Practice Address - Street 1:700 CEDAR ST
Practice Address - Street 2:SUITE 44
Practice Address - City:ALEXANDRIA
Practice Address - State:MN
Practice Address - Zip Code:56308-1769
Practice Address - Country:US
Practice Address - Phone:320-815-5711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-05
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNH6026124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist