Provider Demographics
NPI:1306353016
Name:KEISER, HENRY MICHAEL (AGNP-C)
Entity type:Individual
Prefix:MR
First Name:HENRY
Middle Name:MICHAEL
Last Name:KEISER
Suffix:
Gender:M
Credentials:AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7625 CAMARGO ROAD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45243
Mailing Address - Country:US
Mailing Address - Phone:513-770-0820
Mailing Address - Fax:513-528-8147
Practice Address - Street 1:7625 CAMARGO ROAD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45243
Practice Address - Country:US
Practice Address - Phone:513-770-0820
Practice Address - Fax:513-528-8147
Is Sole Proprietor?:No
Enumeration Date:2018-01-03
Last Update Date:2018-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH432359163W00000X
OHAPRN.CNP.021640363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse