Provider Demographics
NPI:1962768994
Name:KEYS, KRISTIN DAWN (APRN, CNP, WHNP-BC)
Entity type:Individual
Prefix:MS
First Name:KRISTIN
Middle Name:DAWN
Last Name:KEYS
Suffix:
Gender:F
Credentials:APRN, CNP, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5939 HARRY HINES BLVD POB#2, 5TH FLOOR SUITE 200
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75390-0001
Mailing Address - Country:US
Mailing Address - Phone:214-645-3888
Mailing Address - Fax:
Practice Address - Street 1:5939 HARRY HINES BLVD POB#2, 5TH FLOOR SUITE 200
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-4145
Practice Address - Country:US
Practice Address - Phone:214-645-3888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-04
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX142954363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200424180AMedicaid
OK340621YLV0Medicare PIN