Provider Demographics
NPI:1174063101
Name:KEYSER, KAREN (LMT,LPN)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:KEYSER
Suffix:
Gender:F
Credentials:LMT,LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 PICKETT RD
Mailing Address - Street 2:
Mailing Address - City:ROUND HILL
Mailing Address - State:VA
Mailing Address - Zip Code:20141-9430
Mailing Address - Country:US
Mailing Address - Phone:703-431-5688
Mailing Address - Fax:
Practice Address - Street 1:5 PICKETT RD
Practice Address - Street 2:
Practice Address - City:ROUND HILL
Practice Address - State:VA
Practice Address - Zip Code:20141-9430
Practice Address - Country:US
Practice Address - Phone:703-431-5688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-23
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0002053780164W00000X
VA0019004725225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No164W00000XNursing Service ProvidersLicensed Practical Nurse