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Individual

MONICA W KEYES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, NP, ANP-C

Contact information

Practice address
2995 N SALISBURY ST, WEST LAFAYETTE, IN 47906-1435
(765) 448-8000
Mailing address
PO BOX 5545, LAFAYETTE, IN 47903-5545
(765) 448-8000

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
28128435A
IN
363LA2200X
Adult Health Nurse Practitioner
Primary
71002946A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000772291
ANTHEM PROVIDER NUMBER
IN
05
200964040
IN
Enumeration date
04/14/2008
Last updated
01/18/2013
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