Basic Information
Provider Information
NPI: 1790766301
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KEIL
FirstName: KAREN
MiddleName: H
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5409 VERN HOLMES DR
Address2:  
City: STEVENS POINT
State: WI
PostalCode: 544828853
CountryCode: US
TelephoneNumber: 7153441600
FaxNumber:  
Practice Location
Address1: 5409 VERN HOLMES DR
Address2:  
City: STEVENS POINT
State: WI
PostalCode: 544828853
CountryCode: US
TelephoneNumber: 7153441600
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/10/2005
LastUpdateDate: 12/12/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X30525WIY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


Home