Male or Other

Keith Priddle FNP-C

Nurse Practitioner in Greenwood, IN(View on Map)

Full Name

Keith Priddle FNP-C

NPI Number

1235676099

NPI Type

Individual Provider

Gender

Male

Enumeration Date

01/31/2017

Specialties

(Taxonomies)

Code

363L00000X
163W00000X

Primary Taxonomy

Yes
No

Licenses

State

Indiana
Indiana

License Number

71007578A
28205187A

Contact
Information

Purpose

Mailing
Location

Address

747 E COUNTY LINE RD STE B
747 E COUNTY LINE RD STE B

City

Greenwood
Greenwood

State

IN
IN

Postal Code

46143-1082
46143-1082

Country

US
US

Telephone Number

(317) 789-9600
(317) 789-9600

Health Information Exchange

Endpoint Type

DIRECT
OTHERS

Endpoint

KPRIDDLE@AMAZING-DIRECT.COM
Updox.com

Endpoint Description

Unknown
Practice Portal

Use

Health Information Exchange (HIE)
Direct

Content Type

CSV

Other

Other Description:
PDF

Affiliation

N
Y

Endpoint Location

747 E County Line Rd Ste BGreenwood, IN461431082US
Premier Family Medicine, LLC747 E County Line Rd Ste BGreenwood, IN461431082US

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 03/31/2021

Provider Address

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