KEYS2MEMORY LLC NPI 1043567647

NPI Information

NPI: 1043567647
Provider Name: KEYS2MEMORY, LLC
Classification: Nurse Practitioner - 363LG0600X
Entity Type: Organization

Specialization: Gerontology

Address:
20 BURROWS ST
MYSTIC, CT
ZIP 06355
Phone: (860) 245-4144
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KEYS2MEMORY, LLC is a gerontology nurse practitioner in Mystic, CT. KEYS2MEMORY, LLC NPI is 1043567647. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

20 BURROWS ST
MYSTIC, CT
ZIP 06355-445
Phone: (860) 245-4144
Fax: (860) 245-4145

The provider's authorized official is Elena Schjavland .
The authorized official title is Owner/provider and has the following contact phone number (860) 245-4144.

The enumeration date for this NPI number is 8/14/2012 and was last updated on 1/7/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2200X	Nurse Practitioner	Adult Health	002017	CONNECTICUT	No
2	363LG0600X	Nurse Practitioner	Gerontology	002017	CONNECTICUT	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	004020178	MEDICAID	CONNECTICUT
2	500000409 C00814	MEDICARE PIN	CONNECTICUT
3	P02581	MEDICARE UPIN	CONNECTICUT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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