Individual
KEISHA NANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
KEISHA
Contact information
Practice address
5510 HIGHWAY 53 STE H, HARVEST, AL 35749-8594
(256) 929-1939
Mailing address
5510 HIGHWAY 53 STE UNITH, HARVEST, AL 35749-8590
(256) 929-1939
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
821956311
CRANIAL PROSTHETICS
AL
Enumeration date
09/15/2014
Last updated
09/21/2018
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