MRS. ALICIA BOUDREAUX KEENHOLD (NPI# 1093852675) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093852675 |
| Entity Type | Individual |
| Full Name | MRS. ALICIA BOUDREAUX KEENHOLD |
| Credential | RN |
| Practice Address |
124 Mallard St Greenville SC 29601 |
| Mailing Address |
124 Mallard St Greenville SC 29601-4046 |
| Practice Telephone | 8642411040 |
| Mailing Telephone | 8642411040 |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2018-08-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WP0809X |
Registered Nurse Specialization: Psych/Mental Health, Adult |
115451 | LA | Nursing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | NURSING | 115451 | 01 |
| Street Address |
124 MALLARD ST |
| City | GREENVILLE |
| State | SC |
| Zip Code | 29601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821071945 | Michael A Manley | Counselor | 124 Mallard St, Greenville, SC 29601-4046 | 2005-11-22 |
| 1598366445 | Domonique Holbert | Counselor | 124 Mallard St, Greenville, SC 29601-4046 | 2020-11-06 |
| 1003417536 | Nytear Mcclain | Registered Nurse | 124 Mallard St, Greenville, SC 29601-4046 | 2020-11-02 |
| 1053911172 | Whitney Sanders | Registered Nurse | 124 Mallard St, Greenville, SC 29601-4046 | 2020-10-28 |
| 1790392827 | Kelsey Green | Counselor | 124 Mallard St, Greenville, SC 29601-4046 | 2020-09-23 |
| 1497366140 | Holden Lecroy | Counselor | 124 Mallard St, Greenville, SC 29601-4046 | 2020-08-14 |
| 1942811781 | Jimmy Sercey Jr. | Counselor | 124 Mallard St, Greenville, SC 29601-4046 | 2020-08-14 |
| 1063020105 | Marques Petty | Counselor | 124 Mallard St, Greenville, SC 29601-4046 | 2020-07-15 |
| 1174159677 | Laura Deaton | Registered Nurse | 124 Mallard St, Greenville, SC 29601-4046 | 2020-03-16 |
| 1689207482 | Margaret Cross | Counselor | 124 Mallard St, Greenville, SC 29601-4046 | 2020-02-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700305620 | True Sleep Diagnostics | Clinic/Center | 220 North Main St Ste 500, Pmb 104, Greenville, SC 29601 | 2017-09-12 |
| 1245786813 | Yvette Ombougno | Registered Nurse | 200 University Ridge, Greenville, SC 29601 | 2016-09-01 |
| 1477921823 | Laura Gore Siefert | Registered Nurse | 1 Saint Francis Drive, Greenville, SC 29601 | 2015-09-02 |
| 1821493826 | Sarah Fuller | Counselor | 602 Pettigru St, Greenville, SC 29601 | 2014-11-03 |
| 1689088932 | Chenille Taylor | Nurse Practitioner | 201 N. Main Street, Greenville, SC 29601 | 2014-06-15 |
| 1861827842 | Caritas Counseling Services LLC | Community/Behavioral Health | 111 Hampton Avenue, St Mary's Catholic Church, Greenville, SC 29601 | 2013-09-09 |
| 1568790335 | Lynn A. Victory | Counselor | 710 Pettigru Street, The Cottage, Greenville, SC 29601 | 2009-12-06 |
| 1386971448 | Lisa Speach | Nurse Practitioner | 3 St. Francis Drive, Suite 300, Greenville, SC 29601 | 2009-11-11 |
| 1851528418 | Adam Shawn Riffle | Specialist/Technologist | 175 Patewood Drive, Greenville, SC 29601 | 2009-06-22 |
| 1114178332 | Margaret W. Lee | Psychologist | 412 Pettigru St., Suite C, Greenville, SC 29601 | 2008-10-07 |
| Find all providers in zip 29601 | ||||
| Taxonomy Code | 163WP0809X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Psych/Mental Health, Adult |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346200979 | Eugenia H Yount | Registered Nurse | 1006c W H Smith Blvd, Greenville, NC 27834-5051 | 2006-03-27 |
| 1205150943 | Keith O. Plowden | Registered Nurse | 701 Grove Rd, Suite 200, Greenville, SC 29605-4210 | 2010-03-24 |
| 1538178140 | Pamela Wise Knight | Registered Nurse | 124 Mallard St, Greenville, SC 29601-4046 | 2006-08-05 |
| 1861406696 | Phyllis C Sheldon | Registered Nurse | 124 Mallard St, Greenville, SC 29601-4046 | 2006-07-28 |
| 1114941564 | Sheila Marie Hogan | Registered Nurse | 124 Mallard St, Greenville, SC 29601-4046 | 2006-07-27 |
| 1558382580 | Felicia Dawn Callihan | Registered Nurse | 124 Mallard St, Greenville Mental Health, Greenville, SC 29601-4046 | 2006-07-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124646237 | Joanna Wiseman | Registered Nurse | 142 Nims Spring Dr, Fort Mill, SC 29715-6461 | 2020-07-07 |
| 1851870414 | Soledad Velina | Registered Nurse | 810 Dutch Square Blvd Ste 116, Columbia, SC 29210-7318 | 2018-08-13 |
| 1366870933 | Virginia C. White | Registered Nurse | 301-a Palmetto Park Boulevard, Lexington County Community Mental Health Center, Lexington, SC 29072 | 2013-10-17 |
| 1821243643 | Terri-lynn Lashai Mcdonald | Registered Nurse | 10 Richland Medical Park, Suite B, Columbia, SC 29203 | 2008-11-20 |
| 1427661255 | Amy James | Registered Nurse | 109 Bee St, Charleston, SC 29401-5703 | 2020-08-31 |
| 1689299091 | Logan C Smith | Registered Nurse | 1278 N Lafayette Dr, Sumter, SC 29150-2964 | 2020-06-11 |
| 1609392893 | Letressa Antoinette Flemming | Registered Nurse | 1850 Pineview Dr, Columbia, SC 29209-5085 | 2017-08-18 |
| 1164950374 | Jonathan W Hunt | Registered Nurse | 2100 Charlie Hall Blvd, Charleston, SC 29414-5832 | 2017-06-01 |
| 1083141576 | Rashida Hunter | Registered Nurse | 2100 Charlie Hall Blvd, Charleston, SC 29414-5832 | 2017-05-16 |
| 1891231056 | Lisa Brown | Registered Nurse | 448 Lakeshore Pkwy Ste 205, Rock Hill, SC 29730-4264 | 2017-01-12 |
| Find all providers with the same taxonomy | ||||
| City | GREENVILLE |
| Zip Code | 29601 |
Please comment or provide details below to improve the information on MRS. ALICIA BOUDREAUX KEENHOLD.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.