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Individual

KATHLEEN KEITHLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
340 W LINCOLN ST, BELLEVILLE, IL 62220-1900
(618) 233-6044
(618) 233-3287
Mailing address
340 W LINCOLN ST, BELLEVILLE, IL 62220-1900
(618) 233-6044
(618) 233-3287

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
085-002555
IL
363AM0700X
Medical Physician Assistant
2003029518
MO

Other

Enumeration date
02/17/2006
Last updated
11/05/2007
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