| Ms Dianna Lavee Keeling, FNP | |
|
233 S Main St, Licking, MO 65542-9325 | |
| (573) 674-3011 | |
| (573) 674-4765 |
| Full Name | Ms Dianna Lavee Keeling |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 13 Years |
| Location | 233 S Main St, Licking, Missouri |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609115237 | NPI | - | NPPES |
| 420002899 | Medicaid | MO | |
| 26D0679044 | Other | MO | CLIA |
| 1609115237 | Medicaid | MO | |
| 431560263 | Other | MO | TRICARE |
| P01235241 | Other | MO | RR MCR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 2013002123 (Missouri) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Ozarks Medical Center | West plains, MO | Hospital |
| Mercy St Francis Hospital | Mountain view, MO | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Big Springs Medical Association | 6709871007 | 34 |
| Entity Name | Big Springs Medical Association |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1225045321 PECOS PAC ID: 6709871007 Enrollment ID: O20040416000695 |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Dianna Lavee Keeling, FNP Po Box 47, Licking, MO 65542-0047 Ph: (573) 674-3011 | Ms Dianna Lavee Keeling, FNP 233 S Main St, Licking, MO 65542-9325 Ph: (573) 674-3011 |
Marley Ann Stephan, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 255 W Highway 32, Licking, MO 65542 Phone: 573-674-4470 | |
Emily J Wiseman, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 139 W Highway 32, Licking, MO 65542 Phone: 573-674-3011 Fax: 573-674-4765 |