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Individual
HEIDI M KEESIS
Active
Individual
HEIDI M KEESIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
17824
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA17824
MEDICAL LICENSE
CA
Enumeration date
08/19/2010
Last updated
06/04/2020
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