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Individual

MRS. GRETA LOUISE KEYS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP-BC

Contact information

Practice address
332 E MONTICELLO ST, BROOKHAVEN, MS 39601-3430
(601) 833-3500
(601) 292-6384
Mailing address
332 E MONTICELLO ST, BROOKHAVEN, MS 39601-3430
(601) 833-3500
(601) 292-6384

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
363LF0000X
Family Nurse Practitioner
Primary
R843927
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04187246
MS
01
2014619
CIGNA
MS
01
P00823061
RAILROAD MEDICARE
MS
Enumeration date
08/02/2006
Last updated
03/07/2017
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