Provider Demographics
NPI:1063714897
Name:KEIERLEBER, KEITH LEE (RN, CNOR, CRNFA)
Entity type:Individual
Prefix:MR
First Name:KEITH
Middle Name:LEE
Last Name:KEIERLEBER
Suffix:
Gender:M
Credentials:RN, CNOR, CRNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3618 STAMPEDE TRL
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59105-5644
Mailing Address - Country:US
Mailing Address - Phone:406-698-3362
Mailing Address - Fax:
Practice Address - Street 1:2900 12TH AVE N
Practice Address - Street 2:SUITE 315W
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-7506
Practice Address - Country:US
Practice Address - Phone:406-237-5760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-30
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTRN22584163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant