| Doctor Name: | GRETCHEN KEYSE |
| NPI Number: | 1356744585 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CNP |
| License Number: | A004104 |
| Business Practice Address: | 215 N 4th St Dardanelle, AR - 728343713 |
| Business Phone Number: | 4792292827 |
| Business Fax Number: | 4792295749 |
| Mailing Address: | 215 N 4th St, Po Box 637 DARDANELLE |
| State: | AR |
| Postal Code: | 728343713 |
| Phone Number: | 4792292827 |
| Fax Number: | 4792295749 |
| NPI Enumeration Date: | 10/02/2014 |
| NPI Last Update Date: | 10/02/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | A004104 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |