Provider Demographics
NPI:1528691300
Name:KEETER, MORGAN (NP-C)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:KEETER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12390 OLD 125 RD
Mailing Address - Street 2:
Mailing Address - City:SCOTLAND NECK
Mailing Address - State:NC
Mailing Address - Zip Code:27874-9252
Mailing Address - Country:US
Mailing Address - Phone:252-532-7063
Mailing Address - Fax:
Practice Address - Street 1:529 BECKER DR
Practice Address - Street 2:
Practice Address - City:ROANOKE RAPIDS
Practice Address - State:NC
Practice Address - Zip Code:27870-3303
Practice Address - Country:US
Practice Address - Phone:252-537-6465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-19
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5012878363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily