Provider Demographics
NPI:1487364840
Name:KEY, FELICIA MARLICE (LPN)
Entity type:Individual
Prefix:
First Name:FELICIA
Middle Name:MARLICE
Last Name:KEY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1135 POTOMAC RD
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30338-6979
Mailing Address - Country:US
Mailing Address - Phone:404-468-7089
Mailing Address - Fax:
Practice Address - Street 1:6811 LOUISE LN
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-3328
Practice Address - Country:US
Practice Address - Phone:404-468-7089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLP47881164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse