Provider Demographics
NPI:1801462577
Name:NAIL, KEELIE ANN (PT, DPT)
Entity type:Individual
Prefix:
First Name:KEELIE
Middle Name:ANN
Last Name:NAIL
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 N 36TH ST
Mailing Address - Street 2:
Mailing Address - City:MUSKOGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74401-1809
Mailing Address - Country:US
Mailing Address - Phone:918-683-4621
Mailing Address - Fax:918-683-4002
Practice Address - Street 1:1111 N 36TH ST
Practice Address - Street 2:
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74401-1809
Practice Address - Country:US
Practice Address - Phone:918-683-4621
Practice Address - Fax:918-683-4002
Is Sole Proprietor?:No
Enumeration Date:2021-06-02
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK60002251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics