Provider Demographics
NPI:1144927831
Name:KEEKSANDCO
Entity type:Organization
Organization Name:KEEKSANDCO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KYRSTIN
Authorized Official - Middle Name:BRIANNA
Authorized Official - Last Name:DRANEY
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LDN
Authorized Official - Phone:919-609-4261
Mailing Address - Street 1:3612 COLBY CHASE DR
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27539-9056
Mailing Address - Country:US
Mailing Address - Phone:919-609-4261
Mailing Address - Fax:
Practice Address - Street 1:3612 COLBY CHASE DR
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27539-9056
Practice Address - Country:US
Practice Address - Phone:919-609-4261
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty