Provider Demographics
NPI:1194069146
Name:KEATON, COURTNEY MEREDITH (RN)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:MEREDITH
Last Name:KEATON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38032 EDGE MEADOW CT
Mailing Address - Street 2:
Mailing Address - City:NORTH RIDGEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44039-5126
Mailing Address - Country:US
Mailing Address - Phone:440-281-9525
Mailing Address - Fax:
Practice Address - Street 1:38032 EDGE MEADOW CT
Practice Address - Street 2:
Practice Address - City:NORTH RIDGEVILLE
Practice Address - State:OH
Practice Address - Zip Code:44039-5126
Practice Address - Country:US
Practice Address - Phone:440-281-9525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-15
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH333231163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse