Individual
LAURA N KEITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
421 S 28TH AVE, HATTIESBURG, MS 39401-7236
(601) 268-5640
(601) 261-3507
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 268-5640
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RS14087
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00125348
—
MS
05
—
1582280
—
LA
01
—
3513360
AMERICAN ADMIN GROUP
MS
Enumeration date
07/15/2006
Last updated
08/23/2016
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