Tamara Lynn Keys, LPN

Individual provider Active NPI Licensed Practical Nurse · Central Square, NY

NPI 1780101220 · NPPES record last updated Jul 21, 2022

Key facts

NPI
1780101220
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
329583-1 (NY)
Practice address
344 Hickory Lane
Central Square, NY 13036
Phone
(315) 676-9070
NPI assigned
Aug 25, 2017
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
329583-1NYMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 329583-1 NY Yes

Addresses

Primary practice location

344 Hickory Lane
Central Square, NY 13036

Mailing address

344 Hickory LN
Central Square, NY 13036-2622
Phone (315) 676-9070

Other identifiers

IdentifierTypeStateIssuer
329583-1OtherNYLICENSED PRACTICAL NURSE

Other providers in Central Square, NY

All providers in Central Square, NY · Licensed Practical Nurse in New York

Sources for this page

Verify at the official NPI Registry.