Provider Demographics
NPI:1730553371
Name:KEYES, MARY ELIZABETH (PMHNP-BC)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:ELIZABETH
Last Name:KEYES
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:MS
Other - First Name:MARY
Other - Middle Name:ELIZABETH
Other - Last Name:KERVANDJIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:14 CEDAR ST # 107A
Mailing Address - Street 2:
Mailing Address - City:AMESBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01913-1831
Mailing Address - Country:US
Mailing Address - Phone:978-358-1898
Mailing Address - Fax:978-358-1899
Practice Address - Street 1:14 CEDAR ST # 107A
Practice Address - Street 2:
Practice Address - City:AMESBURY
Practice Address - State:MA
Practice Address - Zip Code:01913-1831
Practice Address - Country:US
Practice Address - Phone:978-358-1898
Practice Address - Fax:978-358-1899
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-19
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH088764-23363LP0808X
MARN2371789363LP0808X
PASP023644363LP0808X
PA638050163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse