Charlotte Keith

Individual provider Active NPI Licensed Practical Nurse · Culloden, WV

NPI 1154038719 · NPPES record last updated Nov 3, 2022

Key facts

NPI
1154038719
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
19714 (WV)
Practice address
1992 Route 60
Culloden, WV 25510
Phone
(681) 347-1232
NPI assigned
Nov 3, 2022
Sex
Female
Sole proprietor
Yes

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
19714WVMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 19714 WV Yes

Addresses

Primary practice location

1992 Route 60
Culloden, WV 25510

Mailing address

900 Virginia St E Ste 400
Charleston, WV 25301-2835
Phone (681) 313-4759

Electronic endpoints

TypeEndpointUseAffiliation
Other URL MaximCareMobile Maxim Healthcare Services, Inc.

Other providers in Culloden, WV

All providers in Culloden, WV · Licensed Practical Nurse in West Virginia

Sources for this page

Verify at the official NPI Registry.