Holly Keddington, PA-C is a
Physician Assistant based in Waterloo, Wisconsin. Holly Keddington is licensed to practice in Wisconsin (license number 7947-23) and her current practice location is
105 Highland Ter, Waterloo, Wisconsin. She can be reached at her office (for appointments etc.) via phone at
(920) 478-2141.
NPI number for Holly Keddington is 1194458794 and her current mailing address is 105 Highland Ter, Waterloo, Wisconsin. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1194458794.
Provider's Profile
| Full Name | Holly Keddington |
|---|
| Gender | Female |
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| Speciality | Physician Assistant |
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| Location | 105 Highland Ter, Waterloo, Wisconsin |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1194458794
- Provider Enumeration Date: 07/01/2022
- Last Update Date: 09/17/2024
Medical Identifiers
Medical identifiers for Holly Keddington such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1194458794 | NPI | - | NPPES |
| 1194458794 | Medicaid | WI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363A00000X | Physician Assistant | 7947-23 (Wisconsin) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Holly Keddington is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Holly Keddington, PA-C
105 Highland Ter,
Waterloo, WI 53594-2217
Ph: (920) 478-2141 | Holly Keddington, PA-C
105 Highland Ter,
Waterloo, WI 53594-2217
Ph: (920) 478-2141 |
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