Provider Demographics
NPI:1902262777
Name:KEYSER, LAINE (CRNP)
Entity Type:Individual
Prefix:
First Name:LAINE
Middle Name:
Last Name:KEYSER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:301 LIPPINCOTT DR STE 410
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4197
Mailing Address - Country:US
Mailing Address - Phone:856-237-8045
Mailing Address - Fax:856-237-8047
Practice Address - Street 1:1945 ROUTE 70 E STE D
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-2160
Practice Address - Country:US
Practice Address - Phone:856-237-8045
Practice Address - Fax:856-237-8047
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-11
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00633400363LA2200X
PASP015794363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health