Patricia B. Keller, DPH
Individual provider Active NPI Pharmacist · Newbern, TN
NPI 1023036399 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1023036399
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 4495 (TN)
- Practice address
- 625 W Main St # West
Suite D
Newbern, TN 38059-1572 - Phone
- (731) 627-9573
- Fax
- (731) 627-3051
- NPI assigned
- Jul 17, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 4495 | TN | Yes |
Addresses
Primary practice location
625 W Main St # West
Suite D
Newbern, TN 38059-1572
Mailing address
PO Box 726
1907 Lake Road
Dyersburg, TN 38025-0726
Phone (731) 286-0648
Other providers in Newbern, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.