Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Keith A. Egly

Individual provider Family Nurse Practitioner · NPI 1790451730

Keith A. Egly is a Family Nurse Practitioner in Churubusco, Indiana. Licensed in West Virginia. Registered with an NPI since 2021.

Licensed in
WV
In the registry since
2021

Practice location Address checks out

8415 State Road 205
Churubusco, IN 46723-9234
Phone: (260) 417-2775
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 110355 (WV)

Record details

NPI number1790451730
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 19, 2021
Last updated in NPPESAugust 19, 2021
Certification dateAugust 19, 2021
Mailing address8415 State Road 205, Churubusco, IN 46723-9234

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