Provider Demographics
NPI:1487373122
Name:FRANCE, KEITIA TENEE
Entity type:Individual
Prefix:
First Name:KEITIA
Middle Name:TENEE
Last Name:FRANCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3009 OAK HAMMOCK LN APT C
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301-9108
Mailing Address - Country:US
Mailing Address - Phone:313-909-3807
Mailing Address - Fax:
Practice Address - Street 1:3009 OAK HAMMOCK LN APT C
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-9108
Practice Address - Country:US
Practice Address - Phone:313-909-3807
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-25
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374J00000X
MA326684174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
No374J00000XNursing Service Related ProvidersDoula