MARY JEANNE KEITH RN, CNP
NPI 1396733739
Nurse Practitioner - Gerontology in Minnetonka, MN

Q: What is Mary Keith's NPI number?

The NPI number for Mary Keith is 1396733739. It was assigned to this individual provider in the NPPES registry on October 10, 2005.

Q: What is Mary Keith's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Q: When was this NPI record last updated?

The NPPES record for Mary Keith was last updated on September 7, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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 October 10, 2005

401 CARLSON PARKWAY, CP340, MINNETONKA, MN 55305(952) 992-3604(612) 866-0459 Get Directions Write a Review

NPPES record last updated: September 7, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Mary Jeanne Keith Rn, Cnp NPPES

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

MARY JEANNE KEITH RN, CNP (NPI 1396733739) is an individual gerontology provider in Minnetonka, Minnesota, licensed in Maryland (136908-23) and active in the NPI registry since October 2005.

NPPES Registry Identity

NPI1396733739

Entity TypeIndividualFemale

Primary Taxonomy363LG0600X

Provider Legal NameMARY JEANNE KEITHCredential: RN, CNP

Location Address401 CARLSON PARKWAY, CP340Minnetonka, MN 55305-5387

Mailing Address1718 W 66th StRichfield, MN 55423-2138 · (612) 861-1080 · Fax (612) 866-0459

Phone(952) 992-3604

Fax(612) 866-0459

Sole ProprietorYes

Enumeration DateOctober 10, 2005

Last NPPES UpdateSeptember 7, 2011

✔ NPI 1396733739 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LG0600X

License✔ Licensed in MD · 136908-23

401 CARLSON PARKWAY, Minnetonka, MN 55305

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Other Identifiers 3

Medicaid553215900MN

Medicare UPINR94984MN

Medicare ID-Type Unspecified500002369MN

Other Providers at the Same Location NPPES 3

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

SUSAN LEE KISSELL RN, CNP

Nurse Practitioner (Gerontology)

401 CARLSON PARKWAY
MINNETONKA, MN 55305

Hennepin County (952) 992-3612

MRS. BEVERLY LYNN WOODBURY RN, CNP

Nurse Practitioner (Gerontology)

401 CARLSON PARKWAY
MINNETONKA, MN 55305

Hennepin County (952) 992-3637

KJIRSTEN PEARSON PHARM D., RPH

Pharmacist

401 CARLSON PARKWAY, CP 474
MINNNETONKA, MN 55305

Hennepin County (952) 992-3475

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mary Keith's NPI number?

The NPI number for Mary Keith is 1396733739. It was assigned to this individual provider in the NPPES registry on October 10, 2005.

Where is Mary Keith located?

Mary Keith practices at 401 Carlson Parkway Cp340, Minnetonka, MN 55305. The listed phone number is (952) 992-3604.

What is Mary Keith's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

When was this NPI record last updated?

The NPPES record for Mary Keith was last updated on September 7, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.