Alicia Boudreaux Keenhold in Greenville - Psychiatric/mental Health, Adult
Alicia Boudreaux Keenhold - NPI 1093852675
Alicia Boudreaux Keenhold is a Psychiatric/mental Health, Adult in Greenville, South Carolina. Alicia Boudreaux Keenhold practices all healthcare services and medical treatments related to Psychiatric/mental Health, Adult. The NPI Number for Alicia Boudreaux Keenhold is 1093852675. The last update date is 2018-08-16.
Alicia Boudreaux Keenhold's current location address is 124 Mallard St, Greenville, South Carolina. You can contact this provider via phone number 8642411040. The mailing address for Alicia Boudreaux Keenhold is 124 Mallard St, Greenville, South Carolina. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Alicia Boudreaux Keenhold |
|---|---|
| Address | 124 Mallard St, Greenville, South Carolina |
| Phone Number | 8642411040 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | RN |
NPI Number Detail
| NPI Number | 1093852675 |
|---|---|
| Provider Enumeration Date | 2007-01-31 |
| Last Updated Date | 2018-08-16 |
Provider Mailing Address Detail
| Address | 124 Mallard St |
|---|---|
| City | Greenville |
| State | South Carolina (SC) |
| Post Code | 296014046 |
| Phone Number | 8642411040 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Psychiatric/mental Health, Adult |
|---|---|
| Taxonomy | 163Wp0809X |
| Licence No | 115451 |
|
Definition: A psychiatric nurse who cares for adult patients. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 115451 | LA | NURSING |
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What is the unique 10-digit identification code issued to Alicia Boudreaux Keenhold by the Centers for Medicare & Medicaid Services?
The Alicia Boudreaux Keenhold has been assigned the NPI (National Provider Identifier) 1093852675 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you share the physical location details of Alicia Boudreaux Keenhold?
The Alicia Boudreaux Keenhold is situated at 124 Mallard St, in the city of Greenville, state of SC, with the zip code 296014046.
What is the Alicia Boudreaux Keenhold's specialty and taxonomy code?
The Alicia Boudreaux Keenhold's specialty is Psychiatric/mental Health, Adult, and the corresponding taxonomy code is 163Wp0809X.
On what date did the Alicia Boudreaux Keenhold receive the assignment of its 1093852675 from the Centers for Medicare & Medicaid Services?
The Alicia Boudreaux Keenhold was issued its 1093852675 by the Centers for Medicare & Medicaid Services on 2007-01-31.
As of what date were the Alicia Boudreaux Keenhold's details last updated?
The information pertaining to the Alicia Boudreaux Keenhold, including its address, specialty, and other details, was most recently updated on 2018-08-16.