Individual
AMY KEYWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, CDE
Contact information
Practice address
477 J W DR, MOUNTAIN VIEW, AR 72560-4000
(601) 573-9725
Mailing address
477 J W DR, MOUNTAIN VIEW, AR 72560-4000
(601) 573-9725
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
886083
MS
163WD0400X
Diabetes Educator Registered Nurse
135470
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
710000337
RR MEDICARE
MS
Enumeration date
06/26/2006
Last updated
04/02/2020
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