Individual
JUSTIN THOMAS KEATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
777 HOSPITAL WAY, POCATELLO, ID 83201-5175
(208) 239-1000
Mailing address
261 S 300 W, KAYSVILLE, UT 84037-2448
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
10196201-3102
UT
367500000X
Certified Registered Nurse Anesthetist
Primary
78567
ID
Other
Enumeration date
10/11/2023
Last updated
01/18/2024
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