Jeanna R Keizer, RDH

Individual provider Active NPI Dental Hygienist · Baxter Springs, KS

NPI 1083048342 · NPPES record last updated Aug 22, 2013

Key facts

NPI
1083048342
Entity type
Individual (NPI type 1)
Primary specialty
Dental Hygienist 124Q00000X
License
11149 (KS)
Practice address
2990 Military Ave
Baxter Springs, KS 66713-2331
Phone
(620) 856-2900
Fax
(620) 856-2901
NPI assigned
Aug 22, 2013
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

State licenses

LicenseStateTypeSpecialty
11149KSMDSocial Worker

Interoperability endpoints

  • Direct secure messaging: jeanna.keizer@chcsek.eclinicaldirectplus.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 11149 KS Yes

Addresses

Primary practice location

2990 Military Ave
Baxter Springs, KS 66713-2331

Mailing address

3011 N Michigan St
Pittsburg, KS 66762-2546
Phone (620) 231-9873

Other providers in Baxter Springs, KS

All providers in Baxter Springs, KS · Dental Hygienist in Kansas

Sources for this page

Verify at the official NPI Registry.