Individual
CONNIE KEITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10470 169TH ST W, LAKEVILLE, MN 55044-5584
(952) 769-6656
Mailing address
10470 169TH ST W, LAKEVILLE, MN 55044-5584
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R-165201-7
MN
Other
Enumeration date
05/02/2007
Last updated
10/26/2016
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