Individual
MISS TINA S KEATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
308 DEEP SOUTH FARM RD, SUITE 200, BLAIRSVILLE, GA 30512-2218
(706) 835-2235
(706) 835-1706
Mailing address
1835 SAVOY DR, SUITE 300, ATLANTA, GA 30341-1072
(706) 835-2235
(706) 835-1706
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN107500
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003144263A,B,D
—
GA
Enumeration date
03/05/2014
Last updated
09/01/2020
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