Individual
RAE KEASHLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
705 PLEASANT AVE S, PARK RAPIDS, MN 56470-1440
(218) 732-2800
(218) 732-2857
Mailing address
705 PLEASANT AVE S, PARK RAPIDS, MN 56470-1440
(218) 732-2800
(218) 732-2857
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
38837
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0106547
MEDICA #
MN
01
—
0106730
MEDICA #
MN
01
—
0403067
MEDICA #
MN
01
—
140791
UCARE #
MN
01
—
14173
NDBS #
MN
05
—
18686
—
MN
01
—
23Y87KE
MNBS #
MN
01
—
23Y88KE
MNBS #
MN
01
—
23Y89KE
MNBS #
MN
01
—
8050
SIOUX VALLEY #
MN
01
—
904360
AMERICA'S PPO/ARAZ #
MN
05
—
975817800
—
MN
01
—
DA9041015676
PREFERRED ONE #
MN
01
—
HP25788
HEALTHPARTNERS #
MN
01
—
MN100030
LHS/BANNERHEALTH #
MN
Enumeration date
06/01/2006
Last updated
08/22/2011
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