Nancy Keetch, RD, LD

Individual provider Active NPI Metabolic Nutrition Registered Dietitian · Lake Saint Louis, MO

NPI 1326313909 · NPPES record last updated May 6, 2013

Key facts

NPI
1326313909
Entity type
Individual (NPI type 1)
Primary specialty
Metabolic Nutrition Registered Dietitian 133VN1006X
License
10828 (MO)
Practice address
100 Medical PLZ
Suite 1203
Lake Saint Louis, MO 63367-1366
Phone
(636) 625-5424
NPI assigned
Mar 15, 2012
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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
10828MOMDMetabolic Nutrition Registered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care St. Louis Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Metabolic Nutrition Registered Dietitian 133VN1006X 10828 MO Yes

Addresses

Primary practice location

100 Medical PLZ
Suite 1203
Lake Saint Louis, MO 63367-1366

Mailing address

100 Medical PLZ
Lake St Louis, MO 63367-1366
Phone (636) 625-5424

Other providers in Lake Saint Louis, MO

All providers in Lake Saint Louis, MO · Metabolic Nutrition Registered Dietitian in Missouri

Sources for this page

Verify at the official NPI Registry.