Individual
MR. MICHAEL DENNIS KEITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
A.P.R.N., L.C.A.C.
Contact information
Practice address
619 S MARION AVE, LAKE CITY, FL 32025-5808
(386) 755-3016
(386) 754-6387
Mailing address
619 S MARION AVE, LAKE CITY, FL 32025-5808
(386) 755-3016
(386) 754-6387
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
191
KS
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
45764
KS
Other
Enumeration date
07/26/2013
Last updated
06/29/2023
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