KEITH ALLEN MEDINA RN
NPI 1053085795
Registered Nurse in Glendale, AZ

Q: What is Keith Medina's NPI number?

The NPI number for Keith Medina is 1053085795. It was assigned to this individual provider in the NPPES registry on August 5, 2021.

Q: What is Keith Medina's specialty?

The primary specialty registered for this NPI is Registered Nurse with taxonomy code 163W00000X.

Q: When was this NPI record last updated?

The NPPES record for Keith Medina was last updated on August 5, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 05, 2021

8045 N 47TH AVE, GLENDALE, AZ 85302(623) 435-6300(623) 435-6369 Get Directions Write a Review

NPPES record last updated: August 5, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Keith Allen Medina Rn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KEITH ALLEN MEDINA RN (NPI 1053085795) is an individual registered nurse in Glendale, Arizona, licensed in Arizona (201020) and active in the NPI registry since August 2021.

NPPES Registry Identity

NPI1053085795

Entity TypeIndividualMale

Primary Taxonomy163W00000X

Provider Legal NameKEITH ALLEN MEDINACredential: RN

Location Address8045 N 47TH AVEGlendale, AZ 85302-6402

Mailing Address8045 N 47th AveGlendale, AZ 85302-6402 · (623) 435-6300 · Fax (623) 435-6369

Phone(623) 435-6300

Fax(623) 435-6369

Sole ProprietorYes

Enumeration DateAugust 5, 2021

NPPES CertifiedAugust 5, 2021

✔ NPI 1053085795 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRegistered NurseNursing Service Providers

Taxonomy Code163W00000X

License✔ Licensed in AZ · 201020

Definition

(1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.'s assist patient in recovering and maintaining their physical or mental health. They assist physicians during treatments and examinations and administer medications. (2) A provider who is trained and educated in a formal nursing education program at an accredited school of nursing, passes a national certification examination, and is licensed by the state to practice nursing. The individual provides nursing services to patients or clients in areas such as health promotion, disease prevention, acute and chronic care and restoration and maintenance of health across the life span.

8045 N 47TH AVE, Glendale, AZ 85302

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Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHONTIONN PRIDGON

Registered Nurse (School)