Provider Demographics
NPI:1639962368
Name:KEITH, SIERRA (MSN, CRNP, FNP-C)
Entity type:Individual
Prefix:
First Name:SIERRA
Middle Name:
Last Name:KEITH
Suffix:
Gender:F
Credentials:MSN, CRNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MADISON PARK DR APT 411
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-2052
Mailing Address - Country:US
Mailing Address - Phone:256-654-0547
Mailing Address - Fax:
Practice Address - Street 1:1 MADISON PARK DR APT 411
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-2052
Practice Address - Country:US
Practice Address - Phone:256-654-0547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-26
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-192154163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse