Individual
JERMAINE KEYES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
817 SCR 103, LOUIN, MS 39338-4970
(601) 620-6901
(601) 822-5060
Mailing address
817 SCR 103, LOUIN, MS 39338-4970
(601) 620-6901
(601) 822-5060
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
0000000000
MS
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000000000
—
MS
Enumeration date
11/07/2018
Last updated
11/07/2018
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