DR. ELIZABETH TANNAHILL GLEN KEYMER (NPI# 1336256353) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336256353 |
| Entity Type | Individual |
| Full Name | DR. ELIZABETH TANNAHILL GLEN KEYMER |
| Other Name | ELIZABETH TANNAHILL GLEN KEYMER |
| Credential | PSYD |
| Practice Address |
751 Oak St Ste 120 Jacksonville FL 32204-3359 |
| Mailing Address |
3019 Saint Johns Ave Jacksonville FL 32205-9102 |
| Practice Telephone | 4046836367 |
| Mailing Telephone | 4046836367 |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2016-05-13 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | PY6757 | FL | Behavioral Health & Social Service Providers |
| Street Address |
751 OAK ST STE 120 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32204-3359 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437719853 | North Florida Surgeons, Pa | Orthopaedic Surgery | 2 Shirlciff Ways, Suite 300, Jacksonville, FL 32204 | 2019-06-18 |
| 1770043531 | Manuel Viado Rosas | Physical Therapist | Bold City Therapy and Wellness LLC, 2054 Park Street, Jacksonville, FL 32204 | 2019-03-20 |
| 1255805172 | Tracie Nickole Singh | Marriage & Family Therapist | 1125 W Beaver Street, Suite 205, Jacksonville, FL 32204 | 2019-01-14 |
| 1427548544 | Bold City Therapy and Wellness LLC | Clinic/Center | 2054 Park Street, Jacksonville, FL 32204 | 2018-05-14 |
| 1356883078 | Lcn Enterprise, LLC | Case Manager/Care Coordinator | 1225 W Beaver St Ste 106, Jacksonville, FL 32204 | 2016-11-11 |
| 1073065082 | Prosser and Prosser LLC | Non-emergency Medical Transport (VAN) | 2120 Ernest St, Jacksonville, FL 32204 | 2016-10-26 |
| 1336529817 | Nader Daoud | Internal Medicine | 1 Shircliffway, Jacksonville, FL 32204 | 2015-06-01 |
| 1194119214 | Benjamin James Dionne | Internal Medicine | 2 Shircliff Way Ste 400, Jacksonville, FL 32204 | 2015-03-26 |
| 1598187932 | Jamara Stephens | Counselor | 1225 W Beaver St Ste 205, Jacksonville, FL 32204 | 2014-01-18 |
| 1154743961 | Kathleen Jasper | Nurse Anesthetist, Certified Registered | 2165 Herschel Street, Jacksonville, FL 32204 | 2014-01-14 |
| Find all providers in zip 32204 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447604806 | Rujvi Kamat | Clinical Neuropsychologist | 1235 San Marco Blvd Fl 4, Jacksonville, FL 32207-8554 | 2016-04-21 |
| 1750744405 | Andrew J Ruffett Phd LLC | Clinical Neuropsychologist | 11869 Curlew Way, Jacksonville, FL 32223-1939 | 2016-03-31 |
| 1629499819 | Bay Area Psychology Associates | Clinical Neuropsychologist | 302 Woodberry Pl, Jacksonville, NC 28540-4264 | 2013-12-14 |
| 1356778898 | Behavioral Health of North Florida Pllc | Clinical Neuropsychologist | 3733 University Blvd W Ste 214, Jacksonville, FL 32217-2128 | 2013-09-30 |
| 1093939498 | Christopher Rackley | Clinical Neuropsychologist | 1660 Prudential Dr Ste 210, Jacksonville, FL 32207-8185 | 2007-04-13 |
| 1215989991 | David S Sabsevitz | Clinical Neuropsychologist | 4500 San Pablo Rd S Dept Of, Jacksonville, FL 32224-1865 | 2006-05-17 |
| 1902880537 | Andrew J Ruffett | Clinical Neuropsychologist | 3617 Crown Point Rd, Ste 6, Jacksonville, FL 32257-9010 | 2005-12-06 |
| 1255331237 | Randi Most | Clinical Neuropsychologist | 13400 Sutton Park Dr S, Suite 1504, Jacksonville, FL 32224-0236 | 2005-07-30 |
| 1619973997 | Nicole Annette Hagedorn | Clinical Neuropsychologist | 2680 Henderson Dr Ste 5, Jacksonville, NC 28546-5297 | 2005-06-22 |
| 1477103539 | Adeline Leon | Clinical Neuropsychologist | 841 Prudential Dr Fl 10, Jacksonville, FL 32207-8329 | 2019-09-19 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32204 |
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| 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.