Keithan Ivey
Case Manager/Care Coordinator in Baton Rouge, LA. Individual provider (NPI-1).
NPI number1982439923
StatusActive
Last updated in NPPESSep 6, 2024
Details
- NPI
- 1982439923
- Entity type
- Individual (NPI-1)
- Name
- Keithan Ivey
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 6, 2024
- Certification date
- Sep 6, 2024
- Last updated
- Sep 6, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171M00000X | Case Manager/Care Coordinator | – | – | Yes |
Practice location
11408 Lake Sherwood Ave N Ste ABaton Rouge, LA 70816-0421
Phone 225-261-7143
Mailing address
13406 Arlingford AveBaton Rouge, LA 70815-9410
Phone 936-240-3052
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