Provider Demographics
NPI:1194686741
Name:DEAN, KEYONDA N (NP)
Entity type:Individual
Prefix:
First Name:KEYONDA
Middle Name:N
Last Name:DEAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:KEYANDRA
Other - Middle Name:N
Other - Last Name:DEAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:3332 CENTENNIAL RD
Mailing Address - Street 2:
Mailing Address - City:FOREST HILL
Mailing Address - State:TX
Mailing Address - Zip Code:76119-7153
Mailing Address - Country:US
Mailing Address - Phone:817-710-9502
Mailing Address - Fax:
Practice Address - Street 1:3332 CENTENNIAL RD
Practice Address - Street 2:
Practice Address - City:FOREST HILL
Practice Address - State:TX
Practice Address - Zip Code:76119-7153
Practice Address - Country:US
Practice Address - Phone:817-710-9502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-22
Last Update Date:2025-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1216957363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty